Introduction: Innovations in Care for People With Schizophrenia Spectrum Disorders

What an exciting time to be involved in understanding and providing care for people with schizophrenia spectrum disorders! Just this year, a breakthrough in understanding of the genetics of schizophrenia, a risk calculator for people at risk, and the effectiveness of comprehensive care for people with first-episode schizophrenia in the US were revealed.^1-3

Physical exercise interventions have demonstrated substantial power in reversing cognitive impairments, and novel approaches to psychotherapy that utilize avatars to assist people in experiencing control over hallucinations are being developed.^4-6 Momentum is building to shed the stigma associated with a century-old name and to create a modern nomenclature.

Just this year, a breakthrough in understanding of the genetics of schizophrenia, a risk calculator for people at risk, and the effectiveness of comprehensive care for people with first-episode schizophrenia in the US were revealed.

In this context, we bring you an update on care of people with schizophrenia spectrum disorders in the modern era.

We start with a critique of the updates to the criteria for schizophrenia spectrum disorders in DSM-5. We include reviews of the interface between psychosis and depression and brief cognitive behavioral therapy interventions for people with schizophrenia spectrum disorders.

Then, a beautiful review of the principles of providing culturally competent care is followed by an in-depth illustration of an early psychosis program built to meet the needs of service members within the US military health care system. As a group, these articles emphasize current themes of understanding the patient’s experience, collaborative problem solving, and shared decision-making.

We hope you enjoy this Special Report and are inspired to pick up your game and deliver the best possible care to your patients with lived experience of schizophrenia spectrum disorders.

IN THIS SPECIAL REPORT

Providing Culturally Competent Care: Understanding the Context of Psychosis

Psychotic Disorders in DSM-5: Clinical Implications of Revisions From DSM-IV

Brief Cognitive Behavioral Therapy Interventions for Psychosis

Exploring the Psychosis-Depression Interface: Clinical Implications
 

Disclosures:

Dr. Noordsy is Clinical Professor, Psychiatry and Behavioral Sciences, Stanford Medicine, Stanford, CA. He reports no conflicts of interest concerning the subject matter of this Special Report.

References:

1. Sekar A, Bialas AR, de Rivera H, et al. Schizophrenia risk from complex variation of complement component 4. Nature. 2016;530:177-183.

2. Cannon TD, Changhong Y, Addington J, et al. An individualized risk calculator for research in prodromal psychosis. Am J Psychiatry. July 2016; Epub ahead of print.

3. Kane JM, Robinson DG, Schooler NR, et al. Comprehensive versus usual community care for first-episode psychosis: 2-year outcomes from the NIMH RAISE early treatment program. Am J Psychiatry. 2016;173:362-372.

4. Firth J, Stubbs B, Rosenbaum S, et al. Aerobic exercise improves cognitive functioning in people with schizophrenia: a systematic review and meta-analysis. Schizophr Bull. August 2016; Epub ahead of print.

5. Leff J, Williams G, Huckvale MA, et al. Computer-assisted therapy for medication-resistant auditory hallucinations: proof-of-concept study. Br J Psychiatry. 2013;202:428-433.

6. Craig TK, Rus-Calafell M, Ward T, et al. The effects of an audio visual assisted therapy aid for refractory auditory hallucinations (AVATAR therapy). Trials. 2015;16:349.