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

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

Research output: Contribution to journalArticlepeer-review

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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.
Original languageEnglish
Pages (from-to)71-74
Number of pages4
JournalBJPsych Bulletin
Issue number2
Publication statusPublished - 1 Apr 2014


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