The DOI matches its Crossref record; 84 of the 84 references it cites were found in a registry or an index.
The nature of relapse in schizophrenia
Open accessAbstract
BACKGROUND: Multiple relapses characterise the course of illness in most patients with schizophrenia, yet the nature of these episodes has not been extensively researched and clinicians may not always be aware of important implications. METHODS: We critically review selected literature regarding the nature and underlying neurobiology of relapse. RESULTS: Relapse rates are very high when treatment is discontinued, even after a single psychotic episode; a longer treatment period prior to discontinuation does not reduce the risk of relapse; many patients relapse soon after treatment reduction and discontinuation; transition from remission to relapse may be abrupt and with few or no early warning signs; once illness recurrence occurs symptoms rapidly return to levels similar to the initial psychotic episode; while most patients respond promptly to re-introduction of antipsychotic treatment after relapse, the response time is variable and notably, treatment failure appears to emerge in about 1 in 6 patients. These observations are consistent with contemporary thinking on the dopamine hypothesis, including the aberrant salience hypothesis. CONCLUSIONS: Given the difficulties in identifying those at risk of relapse, the ineffectiveness of rescue medications in preventing full-blown psychotic recurrence and the potentially serious consequences, adherence and other factors predisposing to relapse should be a major focus of attention in managing schizophrenia. The place of antipsychotic treatment discontinuation in clinical practice and in placebo-controlled clinical trials needs to be carefully reconsidered.
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Cites
Kapur, S. (2003) · American Journal of Psychiatry · doi:10.1176/appi.ajp.160.1.13 · Cited by 2,813
The Dopamine Hypothesis of Schizophrenia: Version III--The Final Common Pathway
Howes, O. D., & Kapur, S. (2009) · Schizophrenia Bulletin · doi:10.1093/schbul/sbp006 · Cited by 2,693
Meta-Analysis of Cytokine Alterations in Schizophrenia: Clinical Status and Antipsychotic Effects
Miller, B. J., Buckley, P., Seabolt, W., Mellor, A., & Kirkpatrick, B. (2011) · Biological Psychiatry · doi:10.1016/j.biopsych.2011.04.013 · Cited by 1,742
Marshall, M., Lewis, S., Lockwood, A., Drake, R., Jones, P., & Croudace, T. (2005) · Archives of General Psychiatry · doi:10.1001/archpsyc.62.9.975 · Cited by 1,593
Robinson, D., Woerner, M. G., Alvir, J. M. J., Bilder, R., Goldman, R., Geisler, S., Koreen, A., Sheitman, B., Chakos, M., Mayerhoff, D., et al. (1999) · Archives of General Psychiatry · doi:10.1001/archpsyc.56.3.241 · Cited by 1,327
The Prodromal Phase of First-episode Psychosis: Past and Current Conceptualizations
Yung, A. R., & McGorry, P. D. (1996) · Schizophrenia Bulletin · doi:10.1093/schbul/22.2.353 · Cited by 1,168 · cited 1×
“heralded by a prodromal period lasting months to even years [33], this does not appear to be the case in relapse”
BackgroundHowes, O. D., Kambeitz, J., Kim, E., Stahl, D., Slifstein, M., Abi-Dargham, A., & Kapur, S. (2012) · Archives of General Psychiatry · doi:10.1001/archgenpsychiatry.2012.169 · Cited by 967
Leucht, S., Tardy, M., Komossa, K., Heres, S., Kissling, W., Salanti, G., & Davis, J. M. (2012) · The Lancet · doi:10.1016/s0140-6736(12)60239-6 · Cited by 931 · cited 1×
“However, despite the clearly demonstrated benefits of antipsychotic therapy in relapse prevention [79] it needs to be kept in mind that ongoing maintenance treatment carries its own burden, including substantial risk of relapse [11], significant side-effects and even the possibility of brain morphological changes [80].”
BackgroundNeuroleptics and the Natural Course of Schizophrenia
Wyatt, R. J. (1991) · Schizophrenia Bulletin · doi:10.1093/schbul/17.2.325 · Cited by 787
Natural Course of Schizophrenic Disorders: A 15-Year Followup of a Dutch Incidence Cohort
Wiersma, D., Nienhuis, F. J., Slooff, C. J., & Giel, R. (1998) · Schizophrenia Bulletin · doi:10.1093/oxfordjournals.schbul.a033315 · Cited by 649
Cited by
Galletly, C., Castle, D., Dark, F., Humberstone, V., Jablensky, A., Killackey, E., Kulkarni, J., McGorry, P., Nielssen, O., & Tran, N. (2016) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/0004867416641195 · Cited by 877
Torous, J., Kiang, M. V., Lorme, J., & Onnela, J.-P. (2016) · JMIR Mental Health · doi:10.2196/mental.5165 · Cited by 758
“The negative consequences of relapse in schizophrenia include decreased quality of life, with relationships and employment often in jeopardy [43], as well as likely neurotoxic effects [44], cognitive decline [45], and often a return to an overall lower level of baseline functioning than prior to relapse [46].”
BackgroundImproving outcomes of first‐episode psychosis: an overview
Fusar‐Poli, P., McGorry, P. D., & Kane, J. M. (2017) · World Psychiatry · doi:10.1002/wps.20446 · Cited by 575
Schizophrenia--Time to Commit to Policy Change
Fleischhacker, W. W., Arango, C., Arteel, P., Barnes, T. R. E., Carpenter, W., Duckworth, K., Galderisi, S., Halpern, L., Knapp, M., Marder, S. R., et al. (2014) · Schizophrenia Bulletin · doi:10.1093/schbul/sbu006 · Cited by 214
Baseline Striatal Functional Connectivity as a Predictor of Response to Antipsychotic Drug Treatment
Sarpal, D. K., Argyelan, M., Robinson, D. G., Szeszko, P. R., Karlsgodt, K. H., John, M., Weissman, N., Gallego, J. A., Kane, J. M., Lencz, T., et al. (2016) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2015.14121571 · Cited by 212
Metadata
- Authors
- Emsley, R., Chiliza, B., Asmal, L., & Harvey, B. H.
- Venue
- BMC Psychiatry
- Published
- 2013-02-08
- Volume
- 13
- Issue
- 1
- Pages
- 50-50
- ISSN
- 1471-244X (ISSN-L)
- OpenAlex
- W2165397843
- Cited by
- 478
- References
- 84
- FWCI
- 13.82
- Type
- journal article
- Language
- en
- Open access
- gold
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