NEXT Step Program – Highlights
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After two years of virtual meetings, the 5th edition of the NEXT STEP Program was finally held again in-person in the heart of Budapest. In line with the program’s mission, led by the International Scientific Board – Professors Istvan Bitter, Silvana Galderisi and Peter Falkai – the aim of the two-day event was to engage experts from all around Europe to discuss a timely and important topic, “REMOVING BARRIERS TO RECOVERY IN SCHIZOPHRENIA”.
The first day was primarily about the importance of the caregiver family members in the schizophrenia management and the launch of The Candid Book. Professor Peter Falkai highlighted the role of caregivers in disease management and improving treatment outcomes, Sophia Heimkes talked about her experience as clinical psychologist in supporting caregiver family members, while Andre Decraene, EUFAMI Vice-president, shared his view regarding how being a caregiver impacts one’s personal and social life. Wrapping up the day, a debate inspired by real-life experiences was held, highlighting the challenges of caregiver support.
The second day of the NEXT Step Program was fully packed with interesting lectures by the Board members and invited speakers about factors and barriers to recovery in schizophrenia as well as therapeutic options that increase the chance of recovery in people living with schizophrenia. For instance, Professor Stephan Hjorth talked about the rationale of combining antipsychotic treatments from a pharmacological point of view while Professor Jozef Dragasek shared real-life data from his most recent study conducted in Slovakia where patients improved significantly in social functioning. Professor Maris Taube elaborated on how the safety profiles of antipsychotic medication can impact the treatment outcomes in schizophrenia.
Highlights of the NEXT Step Program
Patients diagnosed with schizophrenia have a 15-20-year shorter life expectancy compared to the general population, mainly attributable to somatic factors – Professor István Bitter
There is an increasing mortality gap: the life expectancy of the general population increased in the period before the COVID pandemic, while this was not the case for people with the diagnosis of schizophrenia.
The main contributors to reduced life expectancy include circulatory, metabolic and respiratory problems, as well as neoplasms.
Young (< 20 years), females patients show an increased risk of mortality.
Antipsychotics-use is a protective factor: moderate-to-high antipsychotic exposure is associated with substantially lower mortality compared to non-use.
Modifiable risk factors, such as smoking, low physical activity and weight gain, should be a focus of treatment.
Physical health problems, such as metabolic syndrome, increase mortality significantly in patients suffering from schizophrenia – Professor Silvana Galderisi
Metabolic syndrome is a combination of risk factors, such as high blood pressure, that affects one’s physical health negatively.
The prevalence of metabolic syndrome is 40% in first-episode schizophrenia patients.
Psychiatrists should assess the risks for metabolic syndrome before prescribing any antipsychotics and choose the right medication based on the outcome of this assessment.
Referring patients to other specialists such as cardiologists or endocrinologists would be important as schizophrenia patients are less likely in general to be screened and treated due to increased stigma.
Depressive symptoms in schizophrenia have a direct negative impact on quality of life and therefore physicians should ask about them frequently – Professor Peter Falkai
Depressive symptoms are part of schizophrenia and are more prevalent in the later phases of the disorder.
Although distinguishing depressive symptoms from negative symptoms is difficult, a few simple questions about the patient’s mood and drive can shed light on potential traces of depression.
Measurement of depression in schizophrenia should be done by using the Calgary Depression Scale for Schizophrenia.
Treatment of depressive symptoms can be achieved using antipsychotics with antidepressant effect or with add-on antidepressants.
Exercise in the form of even 15 minutes of walk a day can have immense positive impact on negative symptoms.
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