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

Abstract

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.

• Authors: G Fond, O Godin, F Schürhoff, F Berna, M André, B Aouizerate, D Capdevielle, I Chereau, T D' Amato, C Dubertret, J Dubreucq, C Faget, C Lançon, S Leignier, J Mallet, D Misdrahi, C Passerieux, B Pignon, R Rey, A Szoke, M Urbach, P Vidailhet, M Leboyer, L Boyer, P M Llorca, FACE-SZ group
• Journal: Progress in neuro-psychopharmacology & biological psychiatry (Prog Neuropsychopharmacol Biol Psychiatry) Vol. 101 Pg. 109927 (07 13 2020) ISSN: 1878-4216 [Electronic] England
• PMID: 32173456 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review)
• Copyright: Copyright © 2020 Elsevier Inc. All rights reserved.

Chemical References

• Antipsychotic Agents

Topics

• Activities of Daily Living (psychology)
• Antipsychotic Agents (therapeutic use)
• Cohort Studies
• Cross-Sectional Studies
• Follow-Up Studies
• France (epidemiology)
• Humans
• Mental Health Services (trends)
• Metabolic Syndrome (epidemiology, psychology, therapy)
• Multicenter Studies as Topic (methods)
• Psychiatric Status Rating Scales
• Quality of Life (psychology)
• Schizophrenia (epidemiology, therapy)
• Schizophrenic Psychology
• Tobacco Smoking (adverse effects, epidemiology, psychology)