Informe nº Osteba D12-04. - Euskadi.net

RESULTSThe guideline proposes remission criteria in accordance with generally-agreed principles at this time,following a review of this subject. It develops definitions of refractory schizophrenia. The paper proposesseveral different levels of strategic evidence of pharmacological-biological treatment, drawing up conclusionsand recommendations for each section. The guideline defines strategies for psychosocial treatmentin Refractory Schizophrenia, proposes these with different levels of evidence, and draws upconclusions and recommendations for each section.CONCLUSIONS AND RECOMMENDATIONS:The team that has drawn up this Guideline proposes the following definition of treatment resistant schizophrenia:those persons who do not reach the minimum remission threshold in accordance with Andreasen’scriteria. With regard to pharmacological/biological treatment strategies, recommendationsand conclusions are made for clozapine, first and second generation antipsychotics, secondary effectsof antipsychotics, antipsychotic polytherapy, antipsychotic enhancements, electroconvulsive therapyand magnetic transcranial stimulation therapy. With regard to psychosocial treatment strategies, a numberof conclusions and recommendations are reviewed and established for: vocational rehabilitation,family interventions, behavioural therapy, cognitive restructuring therapy or cognitive therapy of schizophrenia,psychoeducation, community assertive therapy, group psychotherapy, neuropsychologicalrehabilitation, psychoanalytical and psychodynamic psychotherapies and finally, art therapies or art therapyfor schizophrenia.The guideline is structured according to a gradient of evidence in strategies for dealing with resistantschizophrenia based on pragmatism and utility criteria. We understand that the guideline may be appliedto the evaluation of widely used therapeutic strategies and in this context, may help in the planning ofhealth resources. Special emphasis has been placed on revealing the positive and negative aspects ofcurrent practice in the treatment of treatment resistant schizophrenia and is therefore oriented towardspriorities and requirements of the research in this field.21