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2 results

  • Reimagining psychosis prevention: responding to the accessibility issues of At-Risk Mental State (ARMS) services through a selective public health approach

  • Luke Brown, Siân Lowri Griffiths
  • Journal:
    BJPsych Bulletin , FirstView
    Published online by Cambridge University Press:
    15 January 2025, pp. 1-5
    • Article
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  • At-Risk Mental State (ARMS) services aim to prevent the onset of first-episode psychosis (FEP) in those with specific clinical or genetic risk markers. In England, ARMS services are currently expanding, but the accessibility of this preventative approach remains questionable, especially for a subgroup of FEP patients and those from specific ethnic minority communities. This commentary outlines the key debates about why a complimentary approach to psychosis prevention is necessary, and gives details for an innovative public health strategy, drawing on existing research and health prevention theory.

  • Chapter 5.3 - Drug Treatment of the Psychoses

  • Edited by David Kingdon, University of Southampton, Paul Rowlands, Derbyshire Healthcare NHS foundation Trust, George Stein, Emeritus of the Princess Royal University Hospital
  • Book:
    Seminars in General Adult Psychiatry
    Published online:
    04 April 2024
    Print publication:
    18 April 2024, pp 241-281

  • Summary

    The chapter describes the history, mechanisms and phases of drug treatment of antipsychotics including at-risk mental states (ARMS), first-episode psychosis (FEP), maintenance, treatment-resistant schizophrenia (TRS) and ultra-resistant psychosis. Specific treatments of schizoaffective disorder, catatonia and affective comorbidities of psychosis target negative symptoms and cognition. Rapid tranquilisation is described: general principles, de-escalation, routes of administration and medication selection. Management of organic psychotic disorders is discussed: general principles and specific conditions, epilepsy, Huntington’s, stroke, drug-induced, autoimmune encephalitis, inflammatory, CNS infections, thyroid disorders and traumatic brain injury. Side effects are elaborated: somnolence and sedation; hyperprolactinaemia and sexual dysfunction; motor, cardiac, metabolic and anticholinergic side effects; and also diabetes and impaired glucose tolerance and clozapine-specific side effects. Finally, potential drug interactions are explored.