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Unheard voices: outcomes of tertiary care for treatment-refractory psychosis

Research output: Contribution to journalArticlepeer-review

S. Neil Sarker, Derek K. Tracy, Maria-Jesus Mateos Fernandez, Natasza Nalesnik, Gurbinder Dhillon, Juliana Onwumere, Anne-Marye Prins, Karen Schepman, Tracy Collier, Thomas P. White, Anita Patel, Fiona Gaughran, Sukhwinder Shergill

Original languageEnglish
Pages (from-to)71-74
Number of pages4
JournalBJPsych Bulletin
Issue number2
Accepted/In press12 Jul 2013
Published1 Apr 2014


King's Authors


Aims and method: In up to a quarter of patients, schizophrenia is resistant to standard treatments. We undertook a naturalistic study of 153 patients treated in the tertiary referral in-patient unit of the National Psychosis Service based at the Maudsley Hospital in London. A retrospective analysis of symptoms on admission and discharge was undertaken using the OPCRIT tool, along with preliminary economic modelling of potential costs related to changes in accommodation.

Results: In-patient treatment demonstrated statistically significant improvements in all symptom categories in patients already identified as having schizophrenia refractory to standard secondary care. The preliminary cost analysis showed net savings to referring authorities due to changes from pre- to post-discharge accommodation.

Clinical implications: Despite the enormous clinical, personal and societal burden of refractory psychotic illnesses, there is insufficient information on the outcomes of specialised tertiary-level care. Our pilot data support its utility in all domains measured.

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