The Practice Essentials of Schizophrenia: A 10-Part CME Series

Schizophrenia is one of the most difficult diagnostic and therapeutic challenges those in the psychiatry and neurology specialities will encounter in their practice. A lack of consensus regarding the disorder’s diagnostic criteria, etiology, and pathophysiology coupled with a dearth of effective treatments creates a confusing landscape for clinicians to navigate. 

To help deepen the clinical understanding of schizophrenia, CME Institute has created this 10-part series in partnership with The Journal of Clinical Psychiatry, including four ACCME-accredited CME video activities and six non-CME commentaries. Led by Dawn I. Velligan, professor and co-director of the division of schizophrenia and related disorders at the University of Texas Health Science Center in San Antonio, and Sanjai Rao, MD, a clinical professor at the University of California, San Diego, the series offers the latest information and guidance for clinical diagnosis, treatment, and management of schizophrenia. 

CME Institute Schizophrenia Activities

The accredited educational opportunities are intended for psychiatrists, psychiatry PAs, and psychiatry NPs. Each activity is worth 0.50 AMA PRA Category 1 Credit™, 0.50 for participation, for a total of two credits to complete the entire series.

Part 1: A Review of Schizophrenia

Review the diagnostic criteria that defines recovery in schizophrenia by establishing patient-centered treatment goals for remission and recovery from schizophrenia as well as the assessment of patients with schizophrenia for unmet needs in current treatment. 

Part 2: Chasing Cognitive and Negative Symptoms: Unmet Treatment Needs of Patients with Schizophrenia 

Negative symptoms are defined as an absence or lack of normal mental reasoning involving thinking, behavior, and perception. They contribute to poor functional outcomes in schizophrenia. In this activity, learn to evaluate the different symptom domains and understand the disorder’s reward circuitry to help with intervention and assist patients in leading more fulfilling lives. 

Part 3: Impact of Side Effects on Adherence to Schizophrenia Treatment

The goal of schizophrenia treatment is to control symptoms, prevent relapse, and improve functioning and quality of life. For many patients, these goals are not met, and as a result, recovery rates in schizophrenia don’t improve. In this activity, you’ll learn how to measure adverse effects of schizophrenia treatments and evaluate their impact on adherence.   

Part 4: Balancing Safety and Efficacy with Novel Schizophrenia Treatments

Striking the right balance between symptoms and side effects can be a challenge when treating patients with schizophrenia. In this activity, you’ll learn about new approaches to treatment plus  some promising therapies in the pipeline. 

Journal Commentaries

The Epidemiology and Global Burden of Schizophrenia

Schizophrenia ranks among the top 10 causes of global disability. In the US alone, the average potential life lost for individuals with the condition is 28.5 years. Schizophrenia carries a financial burden as well, with a total lifetime cost to the economy of approximately $3.8 million (or $92,000 per year per patient). In this commentary, the authors outline how a schizophrenia diagnosis typically unfolds and how it affects the individual patient and patients in general. 

Defining and Achieving Treatment Recovery in Schizophrenia

Continued advances in pharmacotherapies and psychosocial interventions have transformed expectations for patient outcomes in schizophrenia, according to this commentary. By more closely aligning treatments to the individual interests of patients, psychiatrists and other ancillary clinicians can elevate the likelihood of continued patient compliance to medication, improve satisfaction with care, and ultimately facilitate more complete recoveries in those with schizophrenia, they write. 

Schizophrenia: Salient Symptoms and Pathophysiology

Patients diagnosed with schizophrenia experience varying degrees of impairment that detract significantly from their quality of life. Addressing those symptoms should take precedence in a patient’s recovery, Velligan and Roa write. By better understanding the changes in brain structure that lead to this disabling disorder, researchers can develop the next generation of therapies that can address all symptoms more effectively. 

Adverse Events and Treatment Adherence in Schizophrenia

In a physician survey, respondents noted that the tolerability of therapies was one of the most serious problems they encountered while treating patients with schizophrenia. The respondents gave treatment-emergent adverse events (TEAEs ) a score of 7.5/10, with a value of 10 representing the greatest need to address a problem possible. Here, the authors describe the myriad challenges to treatment adherence and suggest strategies for overcoming them. 

Optimizing Therapy Selection, Sequencing in Schizophrenia

Selecting the optimal choice for antipsychotic pharmacotherapies in patients with first-episode psychosis can prove challenging, as no findings to date have established superiority for a specific agent. This discussion covers all of the available options, including advice on how to mitigate adverse side effects. The authors make a case for continuing research into alternative treatments that will increase the likelihood of a patient achieving a full recovery.

The Emerging Treatment Landscape in Schizophrenia

The final installment in this series covers the six investigational agents for the treatment of schizophrenia that have entered late-stage development. The next generation of treatments, the authors write, is poised to transform existing therapeutic paradigms and substantially improve outcomes for patients. To maximize the benefits of this expanding the treatment landscape, they urge clinicians to work closely with their patients to determine the most appropriate choice for long-term management. A strong therapeutic alliance ensures that patients achieve the best outcome possible from continued pharmacotherapy.