Table 1 Criteria for referral to the NPS, based on Department of Health Guidelines (DoH, 2009)
From: Skating on thin ice: pragmatic prescribing for medication refractory schizophrenia
Criteria for complex and/or refractory disorder services | |
|---|---|
Generic complex/refractory criteria | Specific to a psychosis centre |
Diagnostic uncertainty hampering treatment | Failure to respond adequately (or tolerate) two antipsychotics (at least one atypical) |
Persistently high symptom burden | |
Significant impact on functioning | Attempted adequate trial of clozapine, usually for a minimum of 6–9 months |
Persisting (>2 years) pattern of incapacity despite appropriate treatment | |
Multiple comorbidities increasing likelihood of chronicity | Appropriate psychological therapies such as cognitive behavioural therapy and family interventions should have been attempted |
Need for specialised treatments, e.g. TMS | |
Inpatient stay >6-12 months | |