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First Episode Schizophrenia-Spectrum Disorders: Wh ...
Presentation Q&A
Presentation Q&A
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Video Transcription
So, a couple of questions came in. The first one is, how often do you see these first episode patients? Okay. And that varies based on the special care treatment model. For those of you who are interested, because there are several of them, they do differ slightly in terms of the frequency, in terms of patients being seen. I can tell you in the RAISE ETP study, what we told prescribers is, they need to see the patient at least once a month. And each of those visits had to be at least 30 minutes. Now, people often ask, well, if a patient has become, quote, stable, do I really have to see them every month? And do I really have to see them for 30 minutes? One of the things is going back to the Hawk family, and the idea that you have to watch people very carefully. Because again, what you're really trying to do for most patients, once they get out of the initial episode, you're wanting to keep them well. And so, that was our rationale about why you have to continue to assess people, see them, monitor them for side effects, et cetera, at least once a month. Now, when somebody is in an acute episode, obviously, they get seen much more, they may need to be seen much more frequently. Again, to sort of help them through a period when they're much more symptomatic. But some people, especially, unfortunately, nowadays, most patients are discharged from inpatient units, still very symptomatic. So, if you have a patient, a typical patient who's just an intake from an inpatient unit, you obviously are going to need to see them sometimes several times a week, just to keep, because they are still so symptomatic. But when they're better, try at least for the once a month. Are there any indicators to suss out who would benefit from an antidepressant? One thing is people with first episode tend to have less severe negative symptoms than your typical multi-episode patient population. So, one of the things is to think about, talk to the patient, if they're being sad or depressed or unhappy, what sort of things lead to that? And what you will often see with first episode is that it's really a reaction to their positive symptoms, because they still have emotional responses often to their positive symptoms. Positive symptoms. So, again, the neighbor's trying to kill me, that makes me anxious and depressed. I didn't do anything to that man, but he's doing all these terrible things. And in that sort of case, you may often say, well, maybe if we just treat that, maybe the unhappiness will go away. People or patients who, again, are very engaged in some of the psychotherapeutic parts of the program. So, for example, in the Navigate program, there are specific whole parts of the psychotherapy modules about dealing with depression and anxiety. And so, some patients really like that. Really like that. And again, you can sort of say, well, that person, maybe they're not going to have something I need to give an antidepressant for. Now, if you have somebody who seems to have a very autonomous mood episode, they're melancholic, very severely depressed, or don't seem to engage in some of these other modalities, then obviously that person you would clinically be much more likely to give an antidepressant. There aren't really strong guidelines about exactly which patient you give an antidepressant to and which ones you don't. I wish we had those. But I think the important thing is just think about it carefully. Yeah. And then you're going to fall back on your clinical judgment. Wonderful. So, it looks like that's all the time we have for questions today.
Video Summary
The video discusses the frequency of seeing first episode patients in special care treatment models. In the RAISE ETP study, it was recommended to see patients at least once a month for a minimum of 30 minutes. This is necessary to monitor their progress, assess for side effects, and ensure their well-being. During acute episodes, patients may need to be seen more frequently, especially if they were discharged from inpatient units still symptomatic. Indicators to consider prescribing antidepressants include less severe negative symptoms, emotional responses to positive symptoms, engagement in psychotherapy modules, and autonomous mood episodes. There are no strict guidelines, but clinical judgment should be used. No credits are mentioned in the transcript for the video summary.
Keywords
special care treatment models
RAISE ETP study
patient monitoring
antidepressant prescribing indicators
clinical judgment
Funding for SMI Adviser was made possible by Grant No. SM080818 from SAMHSA of the U.S. Department of Health and Human Services (HHS). The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement by, SAMHSA/HHS or the U.S. Government.
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