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The Royal College of Psychiatrists Improving the lives of people with mental illness


National Audit of Schizophrenia

Background and standards

Physical healthcare in severe mental illness

Why focus on schizophrenia?

Schizophrenia is a national priority and was the topic for the first ever guideline published by the National Institute of Clinical Excellence (NICE).  It is often a long-term, sometimes life-long, condition that affects about 250,000 people in England and Wales.  As well as causing distressing symptoms such as hearing voices, it can cause lasting impairment and a degree of social exclusion.  Also, people with schizophrenia are more at risk than others of physical ill health and have lower life expectancy.  Antipsychotic medication is effective at treating symptoms and preventing relapse.  However these drugs are associated with a number of side-effects that can cause or contribute to distress and physical ill health.  People who experience these side-effects may discontinue medication and thus be at increased risk of relapse.

Good prescribing for schizophrenia requires achieving a balance between the beneficial and adverse effects of medication, full involvement of the patient in decision-making, close monitoring of physical health and active advice and support regarding health promotion.  There is evidence of both sub-optimal practice and wide variation across clinical teams in important aspects of the management of schizophrenia.


Standards and outcome indicators

The standards were drawn from National Institute of Clinical Excellence (NICE) guidelines, to enable evaluation of:

  • Practice in the prescribing of antipsychotic drugs
  • The quality of physical health monitoring and interventions offered to people with schizophrenia
  • Patients’ experience of treatment and its outcome
  • Carers satisfaction with the support and information they have received





Where next...


papers and links in liaison psychiatry


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