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Psychiatrists' opinion towards medication discontinuation in remitted first‐episode psychosis: A multi‐site study of the Asian Network for Early Psychosis
Author(s) -
Hui Christy L.M.,
Wong Andreas K.H.,
Leung Whitty W.T.,
Lee Edwin H.M.,
Chan Sherry K.W.,
Chang WingChung,
Chen Eric Y.H.,
Chan Tommy C.T.,
Swapna Verma,
Tagata Hiromi,
Tsujino Naohisa,
Nemoto Takahiro,
Mizuno Masafumi,
Kang NamIn,
Kim SungWan,
Chung YoungChul
Publication year - 2019
Publication title -
early intervention in psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.087
H-Index - 45
eISSN - 1751-7893
pISSN - 1751-7885
DOI - 10.1111/eip.12765
Subject(s) - discontinuation , psychiatry , psychosis , checklist , psychology , schizophrenia (object oriented programming) , medicine , clinical psychology , cognitive psychology
Aim The study investigated psychiatrists' views towards the issue of medication discontinuation for patients in remission from first‐episode psychosis in four countries (Hong Kong, Korea, Singapore and Japan) that are part of the Asian Network for Early Psychosis, focusing on whether the views of these countries differ with one another. Methods A questionnaire was distributed to psychiatrists for completion. The questionnaire contained three sections: direct questions probing at views on medication discontinuation, case vignettes to assess applied decision‐making and a checklist of criteria psychiatrists may view as necessary for the patient to satisfy before discontinuation. Total of 484 psychiatrists (97 from Hong Kong, 88 from Korea, 64 from Singapore and 233 from Japan) completed the questionnaire. Results We found that (a) Asian psychiatrists believed that 1% to 19% of remitted patients can discontinue medication, an estimation that was lower than Western psychiatrists; (b) in agreement with clinical guidelines, Asian psychiatrists believed that patients should remain on medication for at least 1 to 2 years following the absence of psychotic symptoms; (c) “Absence of any relapsing episode following first episode” was considered the most important criterion when making a decision; and (d) there were significant differences in clinicians' perceptions across the four countries: for instance, Korean psychiatrists were more conservative with the duration of antipsychotics maintenance, while Singaporean psychiatrists were more open‐minded towards clinical trials. Conclusions Culture and social norms appear to determine the relative importance of factors that psychiatrists might consider during the decision‐making process, thereby producing variations in the views held in different countries.