Confirmations, advances and recommendations for the daily care of schizophrenia based on the French national FACE-SZ cohort - Université Clermont Auvergne Accéder directement au contenu
Article Dans Une Revue (Article De Synthèse) Progress in Neuro-Psychopharmacology and Biological Psychiatry Année : 2020

Confirmations, advances and recommendations for the daily care of schizophrenia based on the French national FACE-SZ cohort

D. Misdrahi
Baptiste Pignon
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Résumé

Background : The National FondaMental Centers of Expertise (FACE) for Schizophrenia (SZ) have been created to shorten the gap between research and clinical practice. Objectives : To synthetize in a review the 10-year findings issued from the FACE-SZ cohort analyses. Methods : More than 1000 patients were evaluated in 10 expert centers since 2010 with a 2-day long comprehensive standardized battery including neuropsychological testes and physical health assessment and followed-up for 3 years. Results : 1. The phase 0 cross-sectional analyses have confirmed well-known data: over-prescription of first-generation antipsychotics, antipsychotic polytherapy and long-term benzodiazepine and under-prescription of clozapine, 13% of drug-induced parkinsonism, 18% of akathisia, a mean duration of untreated psychosis of 18 months, one third of poorly-adherent patients, 24% of metabolic syndrome and 52% of current tobacco smokers with poor care for physical illnesses; a yearly mean financial cost of 15,000 euro/patient. 2. FACE-SZ also yielded additional data in insufficiently explored area: a half of major depression issues (among them one third of undiagnosed major depression and 44% of treated patients with unremitted depression), major depression having a strong impact on Quality of Life independently of negative symptoms, 22% of moderated to severe untreated physical pain. 3. FACE-SZ has explored emerging fields of research, including development of 4 stages- model of schizophrenia, chronic low-grade peripheral inflammation, latent Toxoplasma infection, hypovitaminosis D, and a model for relapse prediction at 2 years. Discussion : The associated factors and implications for public health programs were discussed. Based on the FACE-SZ findings and literature, the FACE-SZ group has yielded recommendations to improve daily care for schizophrenia and for future research.

Dates et versions

hal-02903523 , version 1 (21-07-2020)

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Citer

G. Fond, O. Godin, F. Schürhoff, F. Berna, M. André, et al.. Confirmations, advances and recommendations for the daily care of schizophrenia based on the French national FACE-SZ cohort. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 2020, 101, pp.1-9. ⟨10.1016/j.pnpbp.2020.109927⟩. ⟨hal-02903523⟩
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