Schizophrenia--Time to Commit to Policy Change
Open accessAbstract
Care and outcomes for people with schizophrenia have improved in recent years, but further progress is needed to help more individuals achieve an independent and fulfilled life. This report sets out the current need, informs policy makers and all relevant stakeholders who influence care quality, and supports their commitment to creating a better future. The authors recommend the following policy actions, based on research evidence, stakeholder consultation, and examples of best practice worldwide. (1) Provide an evidence-based, integrated care package for people with schizophrenia that addresses their mental and physical health needs. (2) Provide support for people with schizophrenia to enter and to remain in their community, and develop mechanisms to help guide them through the complex benefit and employment systems. (3) Provide concrete support, information, and educational programs to families and carers on how to enhance care for an individual living with schizophrenia in a manner that entails minimal disruption to their lives. (4) All stakeholders, including organizations that support people living with schizophrenia, should be consulted to regularly revise, update, and improve policy on the management of schizophrenia. (5) Provide support, which is proportionate to the impact of the disease, for research and development of new treatments. (6) Establish adequately funded, ongoing, and regular awareness-raising campaigns that form an integral part of routine plans of action. Implementation of the above recommendations will require engagement by every stakeholder, but with commitment from all, change can be achieved.
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Empirical evidence for focal interventions in first episode psychosis is still limited.
“However, empirical evidence is still limited, and additional studies are welcomed [15].”
From Mindfulness-based social cognition training (SocialMIND) versus psychoeducational multicomponent intervention for people with a first episode of psychosis: A study protocol for a randomised controlled trial (2019) · cites this paper as [15]
The “Encouraging Early Diagnosis and Intervention” section reports evidence that early intervention reduces hospitalizations for 1–2 years after a first episode of psychosis, while saying its longer-term impact is less clear. This supports a need for further evidence on long-term outcomes, but not the broader claim that empirical evidence for first-episode interventions is generally limited. No page number is available in our copy. (LLM, conf=0.82)
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- Hogan P, Dall T, Nikolov P; American Diabetes Association. Economic costs of diabetes in the US in 2002. Diabetes Care. 2003;26:917-932.
- Meltzer HY, Alphs L, Green AI, et al.; International Suicide Prevention Trial Study Group. Clozapine treat- ment for suicidality in schizophrenia: International Suicide Prevention Trial (InterSePT). Arch Gen Psychiatry. 2003;60:82-91.
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Marder, S. R., & Cannon, T. D. (2019) · New England Journal of Medicine · doi:10.1056/nejmra1808803 · Cited by 533 · see citing works
Self-citationGalderisi, S., Rossi, A., Rocca, P., Bertolino, A., Mucci, A., Bucci, P., Rucci, P., Gibertoni, D., Aguglia, E., Amore, M., et al. (2014) · World Psychiatry · doi:10.1002/wps.20167 · Cited by 464 · see citing works
Self-citationEffectiveness, Core Elements, and Moderators of Response of Cognitive Remediation for Schizophrenia
Vita, A., Barlati, S., Ceraso, A., Nibbio, G., Ariu, C., Deste, G., & Wykes, T. (2021) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2021.0620 · Cited by 469 · see citing works
The COVID-19 Global Pandemic: Implications for People With Schizophrenia and Related Disorders
Kozloff, N., Mulsant, B. H., Stergiopoulos, V., & Voineskos, A. N. (2020) · Schizophrenia Bulletin · doi:10.1093/schbul/sbaa051 · Cited by 381 · see citing works
Galderisi, S., Rucci, P., Kirkpatrick, B. W., Mucci, A., Gibertoni, D., Rocca, P., Rossi, A., Bertolino, A., Strauss, G. P., Aguglia, E., et al. (2018) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2017.4607 · Cited by 311 · see citing works
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Self-citationRecovery from schizophrenia: is it possible?
Vita, A., & Barlati, S. (2018) · Current Opinion in Psychiatry · doi:10.1097/yco.0000000000000407 · Cited by 187 · see citing works
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Savitz, A. J., Xu, H., Gopal, S., Nuamah, I. F., Ravenstijn, P. G. M., Janik, A., Schotte, A., Hough, D. W., & Fleischhacker, W. (2016) · The International Journal of Neuropsychopharmacology · doi:10.1093/ijnp/pyw018 · Cited by 160 · see citing works
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Self-citationBugarski‐Kirola, D., Blaettler, T., Arango, C., Fleischhacker, W., Garibaldi, G. M., Wang, A., Dixon, M., Bressan, R. A., Nasrallah, H. A., Lawrie, S. M., et al. (2016) · Biological Psychiatry · doi:10.1016/j.biopsych.2016.11.014 · Cited by 145 · see citing works
Self-citationEEG-Based Measures in At-Risk Mental State and Early Stages of Schizophrenia: A Systematic Review
Perrottelli, A., Giordano, G. M., Brando, F., Giuliani, L., & Mucci, A. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.653642 · Cited by 126 · see citing works
Oliver, L. D., Moxon‐Emre, I., Lai, M., Grennan, L., Voineskos, A. N., & Ameis, S. H. (2020) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2020.3908 · Cited by 115 · see citing works
Transforming the Treatment of Schizophrenia in the United States: The RAISE Initiative
Dixon, L. B., Goldman, H. H., Srihari, V. H., & Kane, J. M. (2018) · Annual Review of Clinical Psychology · doi:10.1146/annurev-clinpsy-050817-084934 · Cited by 112 · see citing works
Durgam, S., Earley, W. R., Li, R., Li, D., Lu, K., Laszlovszky, I., Fleischhacker, W. W., & Nasrallah, H. A. (2016) · Schizophrenia Research · doi:10.1016/j.schres.2016.06.030 · Cited by 103 · see citing works
Self-citationFaber, S. C., Roy, A. K., Michaels, T. I., & Williams, M. T. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1098292 · Cited by 99 · see citing works
Wavelet transforms for feature engineering in EEG data processing: An application on Schizophrenia
Gosala, B., Kapgate, P. D., Jain, P., Chaurasia, R. N., & Gupta, M. (2023) · Biomedical Signal Processing and Control · doi:10.1016/j.bspc.2023.104811 · Cited by 93 · see citing works
Mucci, A., Rucci, P., Rocca, P., Bucci, P., Gibertoni, D., Merlotti, E., Galderisi, S., & Maj, M. (2014) · Schizophrenia Research · doi:10.1016/j.schres.2014.07.044 · Cited by 95 · see citing works
Self-citationA large European, multicenter, multinational validation study of the Brief Negative Symptom Scale
Mucci, A., Vignapiano, A., Bitter, I., Austin, S. F., Delouche, C., Dollfus, S., Erfurth, A., Fleischhacker, W. W., Giordano, G. M., Олегович, Г. И., et al. (2019) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2019.05.006 · Cited by 85 · see citing works
Self-citationHofer, A., Mizuno, Y., Frajo-Apor, B., Kemmler, G., Suzuki, T., Pardeller, S., Welte, A.-S., Sondermann, C., Mimura, M., Wartelsteiner, F., et al. (2016) · Schizophrenia Research · doi:10.1016/j.schres.2016.01.027 · Cited by 83 · see citing works
Self-citationAmato, D., Vernon, A. C., & Papaleo, F. (2017) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2017.09.027 · Cited by 80 · see citing works
Cao, B., Chen, Y., Ren, Z., Pan, Z., McIntyre, R., & Wang, D. (2021) · Neuroscience and Biobehavioral Reviews · doi:10.1016/j.neubiorev.2021.01.018 · Cited by 65 · see citing works
Vita, A., & Barlati, S. (2019) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2019.00147 · Cited by 74 · see citing works
Pong, S., Karmacharya, R., Sofman, M., Bishop, J. R., & Lizano, P. L. (2020) · Complex Psychiatry · doi:10.1159/000511552 · Cited by 71 · see citing works
Involvement of people with schizophrenia in decision-making in rural Ethiopia: a qualitative study
Souraya, S., Hanlon, C., & Asher, L. (2018) · Globalization and Health · doi:10.1186/s12992-018-0403-4 · Cited by 68 · see citing works
Young, A. S., Cohen, A. N., Goldberg, R. W., Hellemann, G., Kreyenbuhl, J., Niv, N., Nowlin-Finch, N., Oberman, R. S., & Whelan, F. (2017) · Journal of general internal medicine · doi:10.1007/s11606-016-3963-0 · Cited by 50 · see citing works
Antipsychotic-Induced Metabolic Syndrome: A Review
Akinola, S., Tardif, I., & Leclerc, J. (2023) · Metabolic Syndrome and Related Disorders · doi:10.1089/met.2023.0003 · Cited by 60 · see citing works
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Self-citationValue of schizophrenia treatment I: The patient journey
Mohr, P., Galderisi, S., Boyer, P., Wasserman, D., Arteel, P., Ieven, A., Kärkkäinen, H., Pereira, E., Guldemond, N., Winkler, P., et al. (2018) · European Psychiatry · doi:10.1016/j.eurpsy.2018.06.007 · Cited by 54 · see citing works
Self-citationFowler, D., Hodgekins, J., & French, P. (2019) · Schizophrenia Research · doi:10.1016/j.schres.2017.10.006 · Cited by 53 · see citing works
Alvarez-Mon, M. A., Llavero-Valero, M., Sánchez-Bayona, R., Pereira-Sanchez, V., Vallejo-Valdivielso, M., Monserrat, J., Lahera, G., Asunsolo del Barco, A., & Alvarez-Mon, M. (2019) · Journal of Medical Internet Research · doi:10.2196/14110 · Cited by 52 · see citing works
Trends in big data analyses by multicenter collaborative translational research in psychiatry
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Self-citationPsychosocial interventions in schizophrenia: Focus on guidelines
Ventriglio, A., Ricci, F., Magnifico, G., Chumakov, E. M., Torales, J. C., Watson, C. J., Castaldelli-Maia, J. M., Petito, A., & Bellomo, A. (2020) · International Journal of Social Psychiatry · doi:10.1177/0020764020934827 · Cited by 48 · see citing works
Lyndon, A. E., Crowe, A., Wuensch, K. L., McCammon, S. L., & Davis, K. B. (2016) · Journal of Mental Health · doi:10.1080/09638237.2016.1244722 · Cited by 45 · see citing works
Variations in Dysbindin-1 are associated with cognitive response to antipsychotic drug treatment
Scheggia, D., Mastrogiacomo, R., Mereu, M., Sannino, S., Straub, R. E., Armando, M., Managò, F., Guadagna, S., Piras, F., Zhang, F., et al. (2018) · Nature Communications · doi:10.1038/s41467-018-04711-w · Cited by 43 · see citing works
Mortality and suicide in schizophrenia: 21-year follow-up in rural China
Ran, M., Xiao, Y., Fazel, S., Lee, Y., Luo, W. P., Hu, S., Yang, X., Liu, B., Brink, M., Chan, S. K. W., et al. (2020) · BJPsych Open · doi:10.1192/bjo.2020.106 · Cited by 42 · see citing works
Granholm, E. L., Holden, J. L., Dwyer, K., Mikhael, T., Link, P. C., & Depp, C. A. (2020) · JMIR Mental Health · doi:10.2196/24406 · Cited by 40 · see citing works
Adipose tissue as a target for second-generation (atypical) antipsychotics: A molecular view
Ferreira, V., Grajales, D., & Valverde, Á. M. (2019) · Biochimica et Biophysica Acta (BBA) - Molecular and Cell Biology of Lipids · doi:10.1016/j.bbalip.2019.158534 · Cited by 39 · see citing works
Zhang, P., & Zhou, X. (2020) · The Science of The Total Environment · doi:10.1016/j.scitotenv.2020.139114 · Cited by 37 · see citing works
COULTER, C., Baker, K. K., & Margolis, R. L. (2019) · Journal of Psychiatric Practice · doi:10.1097/pra.0000000000000363 · Cited by 33 · see citing works
Collo, G., Mucci, A., Giordano, G. M., Pich, E. M., & Galderisi, S. (2020) · Frontiers in Neuroscience · doi:10.3389/fnins.2020.00632 · Cited by 33 · see citing works
Self-citationKalakonda, B., Koppolu, P., & Baroudi, K. (2016) · International Journal of Health Sciences · doi:10.12816/0048820 · Cited by 32 · see citing works
Abu-Akel, A. M., Wood, S. J., Upthegrove, R., Chisholm, K., Lin, A. P., Hansen, P., Gillespie, S. M., Apperly, I. A., & Montag, C. (2022) · Molecular Psychiatry · doi:10.1038/s41380-022-01543-5 · Cited by 32 · see citing works
Giuliani, L., Giordano, G. M., Bucci, P., Pezzella, P., Brando, F., & Galderisi, S. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.791117 · Cited by 29 · see citing works
Self-citationDigital Technology for Caregivers of People With Psychosis: Systematic Review
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Zhang, Y., Tang, Z., Ruan, Y., Huang, C., Wu, J., Lu, Z., Li, W., Tang, Y., Liu, J., She, J., et al. (2018) · Medical Science Monitor · doi:10.12659/msm.913759 · Cited by 28 · see citing works
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The role of dopamine receptors in lymphocytes and their changes in schizophrenia
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Giordano, G. M., Brando, F., Pezzella, P., Angelis, M. D., Mucci, A., & Galderisi, S. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.970210 · Cited by 26 · see citing works
Self-citationLiu, S., Zhang, L., Fan, X., Wang, G., Liu, Q., Yang, Y., Shao, M., Song, M., Li, W., Lv, L., et al. (2023) · Schizophrenia Research · doi:10.1016/j.schres.2023.11.013 · Cited by 26 · see citing works
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Schizophrenia and “unmet needs”: From diagnosis to care in Italy
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Self-citationCrespo‐Facorro, B., Bernardo, M., Argimón, J. M., Arrojo, M., Bravo‐Ortiz, M. F., Cabrera-Cifuentes, A., Román, J. C., Franco, M., García‐Portilla, M. P., Haro, J. M., et al. (2016) · Revista de Psiquiatría y Salud Mental · doi:10.1016/j.rpsm.2016.09.001 · Cited by 21 · see citing works
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Investigating the shared genetic architecture between schizophrenia and body mass index
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Self-citationIntegrated treatment of schizophrenia
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Self-citationAzargoonjahromi, A., & Bahrampour, Z. (2025) · Sleep Medicine · doi:10.1016/j.sleep.2025.106690 · Cited by 17 · see citing works
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Genetic aspects of schizophrenia
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Progress in mechanistically novel treatments for schizophrenia
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Employment-Related Factors of Forensic Psychiatric Outpatients with Psychotic Disorders
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Giuliani, L., Sanmarchi, F., Mucci, A., Rucci, P., Caporusso, E., Bucci, P., Giordano, G. M., Amore, M., Rocca, P., Rossi, A., et al. (2025) · Schizophrenia · doi:10.1038/s41537-024-00545-2 · Cited by 9 · see citing works
Self-citationReal-World Functioning in Psychiatric Outpatients: Predictive Factors
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Altered functional dynamics gradient in schizophrenia with cigarette smoking
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RetractedStępnicki, P., Targowska‐Duda, K. M., Martínez, A. L., Zięba, A., Wronikowska‐Denysiuk, O., Wróbel, M. Z., Bartyzel, A., Trzpil, A., Wróbel, T. M., Chodkowski, A., et al. (2023) · European Journal of Medicinal Chemistry · doi:10.1016/j.ejmech.2023.115285 · Cited by 8 · see citing works
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- Authors
- Fleischhacker, W. W., Arango, C., Arteel, P., Barnes, T. R. E., Carpenter, W., Duckworth, K., Galderisi, S., Halpern, L., Knapp, M., Marder, S. R., Moller, M., Sartorius, N., & Woodruff, P.
- Affiliations
- Innsbruck Medical University (AT)
- Hospital General Universitario Gregorio Marañón (ES)
- Global Alliance of Mental Illness Advocacy Networks-Europe (BE)
- West London Mental Health NHS Trust (GB)
- University of Maryland, Baltimore (US)
- National Alliance on Mental Illness (US)
- University of Campania "Luigi Vanvitelli" (IT)
- King's College London (GB)
- Yale University (US)
- Royal College of Psychiatrists (GB)
- Corresponding author
- Fleischhacker, W. W.
- Venue
- Schizophrenia Bulletin
- Publisher
- Oxford University Press (OUP)
- Published
- 2014-04-01
- Volume
- 40
- Issue
- Suppl 3
- Pages
- S165-S194
- ISSN
- 0586-7614 (ISSN-L)
- 1745-1701
- PMC
- PMC4002061
- OpenAlex
- W2153297237
- Cited by
- 214
- References
- 214
- Citations by year
- 2026: 6 · 2025: 21 · 2024: 31 · 2023: 26 · 2022: 24 · 2021: 31 · 2020: 21 · 2019: 15 · 2018: 11 · 2017: 13 · 2016: 10 · 2015: 2 · 2014: 3
- FWCI
- 7.12
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Schizophrenia Bulletin (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Research Portal (King's College London) (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Health Sciences › Health Professions › General Health Professions › Mental Health and Patient Involvement
- Keywords
- schizophrenia, mental health policy
- MeSH terms
- Community Mental Health Services, Family Therapy, Health Policy, Humans, Patient Education as Topic, Psychotherapy, Quality of Life, Schizophrenia, Social Support, Antipsychotic Agents, Cognitive Behavioral Therapy, Employment, Supported, Evidence-Based Medicine, Recovery of Function, Independent Living
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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