Confirmations, advances and recommendations for the daily care of schizophrenia based on the French national FACE-SZ cohort

Prog Neuropsychopharmacol Biol Psychiatry. 2020 Jul 13;101:109927. doi: 10.1016/j.pnpbp.2020.109927. Epub 2020 Mar 12.

Abstract

Background: The National FondaMental Centers of Expertise (FACE) for Schizophrenia (SZ) have been created to shorten the gap between research and clinical practice.

Objectives: To synthetize in a review the 10-year findings issued from the FACE-SZ cohort analyses.

Methods: More than 1000 patients were evaluated in 10 expert centers since 2010 with a 2-day long comprehensive standardized battery including neuropsychological testes and physical health assessment and followed-up for 3 years.

Results: 1. The phase 0 cross-sectional analyses have confirmed well-known data: over-prescription of first-generation antipsychotics, antipsychotic polytherapy and long-term benzodiazepine and under-prescription of clozapine, 13% of drug-induced parkinsonism, 18% of akathisia, a mean duration of untreated psychosis of 18 months, one third of poorly-adherent patients, 24% of metabolic syndrome and 52% of current tobacco smokers with poor care for physical illnesses; a yearly mean financial cost of 15,000 euro/patient. 2. FACE-SZ also yielded additional data in insufficiently explored area: a half of major depression issues (among them one third of undiagnosed major depression and 44% of treated patients with unremitted depression), major depression having a strong impact on Quality of Life independently of negative symptoms, 22% of moderated to severe untreated physical pain. 3. FACE-SZ has explored emerging fields of research, including development of 4 stages- model of schizophrenia, chronic low-grade peripheral inflammation, latent Toxoplasma infection, hypovitaminosis D, and a model for relapse prediction at 2 years.

Discussion: The associated factors and implications for public health programs were discussed. Based on the FACE-SZ findings and literature, the FACE-SZ group has yielded recommendations to improve daily care for schizophrenia and for future research.

Keywords: Cohort; Daily practice; FACE-SZ; Recommendations; Schizophrenia.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Activities of Daily Living / psychology*
  • Antipsychotic Agents / therapeutic use*
  • Cohort Studies
  • Cross-Sectional Studies
  • Follow-Up Studies
  • France / epidemiology
  • Humans
  • Mental Health Services / trends*
  • Metabolic Syndrome / epidemiology
  • Metabolic Syndrome / psychology
  • Metabolic Syndrome / therapy
  • Multicenter Studies as Topic / methods
  • Psychiatric Status Rating Scales
  • Quality of Life / psychology
  • Schizophrenia / epidemiology*
  • Schizophrenia / therapy*
  • Schizophrenic Psychology*
  • Tobacco Smoking / adverse effects
  • Tobacco Smoking / epidemiology
  • Tobacco Smoking / psychology

Substances

  • Antipsychotic Agents