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dc.contributor.authorEmsley, Robin
dc.contributor.authorHarvey, Brian H.
dc.contributor.authorChiliza, Bonginkosi
dc.contributor.authorAsmal, Laila
dc.date.accessioned2015-04-20T09:23:32Z
dc.date.available2015-04-20T09:23:32Z
dc.date.issued2013
dc.identifier.citationEmsley, R. et al. 2013. The nature of relapse in schizophrenia. BMC psychiatry, 13: Article no 50. [https://doi.org/10.1186/1471-244X-13-50]en_US
dc.identifier.issn1471-244X
dc.identifier.urihttp://hdl.handle.net/10394/13700
dc.identifier.urihttps://doi.org/10.1186/1471-244X-13-50
dc.identifier.urihttps://bmcpsychiatry.biomedcentral.com/articles/10.1186/1471-244X-13-50
dc.description.abstractBackground: 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.en_US
dc.language.isoenen_US
dc.publisherBioMed Centralen_US
dc.subjectSchizophreniaen_US
dc.subjectrelapseen_US
dc.subjectantipsychoticsen_US
dc.subjectdiscontinuationen_US
dc.subjectfirst-episodeen_US
dc.subjectdopamineen_US
dc.titleThe nature of relapse in schizophreniaen_US
dc.typeArticleen_US
dc.contributor.researchID11083417 - Harvey, Brian Herbert
dc.contributor.researchID11083417 - Harvey, Brian Herbert


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