© 1998 by Oxford University Press and the Maryland Psychiatric Research Center (MPRC)
Translating Research Into Practice: The Schizophrenia Patient Outcomes Research Team (PORT) Treatment Recommendations
Principal Investigator of the Schizophrenia Patient Outcomes Research Team, is Professor of Psychiatry, University of Maryland School of Medicine and Co-Director of the Center for Mental Health Services Research, University of Maryland Baltimore, MD
Co-Principal Investigator, is Professor of Health Policy and Management and Chair of the Department of Health Policy and Management, The Johns Hopkins University School of Hygiene and Public Health Baltimore, MD
Reprint requests should be sent to Dr. A.F. Lehman, Dept. of Psychiatry, University of Maryland School of Medicine, 645 West Redwood St., Baltimore, MD 21201
Abstract
Beginning in 1992, the Agency for Health Care Policy and Research and the National Institute of Mental Health funded the Schizophrenia Patient Outcomes Research Team (PORT) to develop and disseminate recommendations for the treatment of schizophrenia based on existing scientific evidence. These Treatment Recommendations, presented here in final form for the first time, are based on exhaustive reviews of the treatment outcomes literature (previously published in Schizophrenia Bulletin, Vol. 21, No. 4, 1995) and focus on those treatments for which there is substantial evidence of efficacy. The recommendations address antipsychotic agents, adjunctive pharmacotherapies, electroconvulsive therapy, psychological interventions, family interventions, vocational rehabilitation, and assertive community treatment/intensive case management. Support for each recommendation is referenced to the previous PORT literature reviews, and the recommendations are rated according to the level of supporting evidence. The PORT Treatment Recommendations provide a basis for moving toward "evidence-based" practice for schizophrenia and identify both the strengths and limitations in our current knowledge base.
Keywords: Mental health services / quality of care
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  P. K. Alexandre, S. S. Martins, and P. Richard Disparities in Adequate Mental Health Care for Past-Year Major Depressive Episodes Among Caucasian and Hispanic Youths Psychiatr Serv, October 1, 2009; 60(10): 1365 - 1371. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. R. Bond, R. E. Drake, G. J. McHugo, C. A. Rapp, and R. Whitley Strategies for Improving Fidelity in the National Evidence-Based Practices Project Research on Social Work Practice, September 1, 2009; 19(5): 569 - 581. [Abstract] [PDF]
|
|
|
|
|
|
J. S. Brekke, E. Phillips, L. Pancake, A. O, J. Lewis, and J. Duke Implementation Practice and Implementation Research: A Report From the Field Research on Social Work Practice, September 1, 2009; 19(5): 592 - 601. [Abstract] [PDF]
|
|
|
|
 |
|
 R. Mojtabai, L. Fochtmann, S.-W. Chang, R. Kotov, T. J. Craig, and E. Bromet Unmet Need for Mental Health Care in Schizophrenia: An Overview of Literature and New Data From a First-Admission Study Schizophr Bull, July 1, 2009; 35(4): 679 - 695. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. R. Falzer, D. M. Garman, and B. A. Moore Examining the Influence of Clinician Decision Making on Adherence to a Clinical Guideline Psychiatr Serv, May 1, 2009; 60(5): 698 - 701. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. D. Mancini, L. L. Moser, R. Whitley, G. J. McHugo, G. R. Bond, M. T. Finnerty, and B. J. Burns Assertive Community Treatment: Facilitators and Barriers to Implementation in Routine Mental Health Settings Psychiatr Serv, February 1, 2009; 60(2): 189 - 195. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Drake, J. Skinner, and H. H. Goldman What Explains the Diffusion of Treatments for Mental Illness? Am J Psychiatry, November 1, 2008; 165(11): 1385 - 1392. [Full Text] [PDF]
|
|
|
|
|
|
H. Ascher-Svanum, A. W. Nyhuis, D. E. Faries, B. J. Kinon, R. W. Baker, and A. Shekhar Clinical, Functional, and Economic Ramifications of Early Nonresponse to Antipsychotics in the Naturalistic Treatment of Schizophrenia Schizophr Bull, November 1, 2008; 34(6): 1163 - 1171. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Bollini, S. Pampallona, S. Nieddu, M. Bianco, G. Tibaldi, and C. Munizza Indicators of Conformance With Guidelines of Schizophrenia Treatment in Mental Health Services Psychiatr Serv, July 1, 2008; 59(7): 782 - 791. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Turkington, D. Kingdon, and P. J. Weiden Cognitive Behavior Therapy for Schizophrenia Focus, April 1, 2008; 6(2): 257 - 266. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Tsai and G. Bond A comparison of electronic records to paper records in mental health centers Int. J. Qual. Health Care, April 1, 2008; 20(2): 136 - 143. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. M. Kane and S. Leucht Unanswered Questions in Schizophrenia Clinical Trials Schizophr Bull, March 1, 2008; 34(2): 302 - 309. [Full Text] [PDF]
|
|
|
|
 |
|
 P. N. Mahadun and M. Marshall Insight and treatment attitude in schizophrenia: comparison of patients on depot and atypical antipsychotics Psychiatr. Bull., February 1, 2008; 32(2): 53 - 56. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. C. Ware, K. Hopper, T. Tugenberg, B. Dickey, and D. Fisher A Theory of Social Integration as Quality of Life Psychiatr Serv, January 1, 2008; 59(1): 27 - 33. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. N. Cohen, S. M. Glynn, A. B. Murray-Swank, C. Barrio, E. P. Fischer, S. J. McCutcheon, D. A. Perlick, A. J. Rotondi, S. L. Sayers, M. D. Sherman, et al. The Family Forum: Directions for the Implementation of Family Psychoeducation for Severe Mental Illness Psychiatr Serv, January 1, 2008; 59(1): 40 - 48. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. J. McHugo, R. E. Drake, R. Whitley, G. R. Bond, K. Campbell, C. A. Rapp, H. H. Goldman, W. J. Lutz, and M. T. Finnerty Fidelity Outcomes in the National Implementing Evidence-Based Practices Project Psychiatr Serv, October 1, 2007; 58(10): 1279 - 1284. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. J. Rivera, A. M. Sullivan, and S. S. Valenti Adding Consumer-Providers to Intensive Case Management: Does It Improve Outcome? Psychiatr Serv, June 1, 2007; 58(6): 802 - 809. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. M. Silverstein Integrating Jungian and Self-Psychological Perspectives Within Cognitive-Behavior Therapy for a Young Man With a Fixed Religious Delusion Clinical Case Studies, June 1, 2007; 6(3): 263 - 276. [Abstract] [PDF]
|
|
|
|
 |
|
 J. M. Noel ASHP Therapeutic Position Statement on the Use of Second-Generation Antipsychotic Medications in the Treatment of Adults with Psychotic Disorders Am. J. Health Syst. Pharm., April 15, 2007; 64(8): 863 - 876. [Full Text] [PDF]
|
|
|
|
|
|
T. B. Sullivan Cognitive Therapy of Schizophrenia Psychiatr Serv, February 1, 2007; 58(2): 277 - 278. [Full Text] [PDF]
|
|
|
|
|
|
J. S. Brekke, K. Ell, and L. A. Palinkas Translational Science at the National Institute of Mental Health: Can Social Work Take Its Rightful Place? Research on Social Work Practice, January 1, 2007; 17(1): 123 - 133. [Abstract] [PDF]
|
|
|
|
|
|
G. S. Cuddeback, J. P. Morrissey, and P. S. Meyer How Many Assertive Community Treatment Teams Do We Need? Psychiatr Serv, December 1, 2006; 57(12): 1803 - 1806. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. A. Cook Employment Barriers for Persons With Psychiatric Disabilities: Update of a Report for the President's Commission Psychiatr Serv, October 1, 2006; 57(10): 1391 - 1405. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. T. Mueser, P. S. Meyer, D. L. Penn, R. Clancy, D. M. Clancy, and M. P. Salyers The Illness Management and Recovery Program: Rationale, Development, and Preliminary Findings Schizophr Bull, October 1, 2006; 32(suppl_1): S32 - S43. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W.-T. Chien, I. Norman, and D. R. Thompson Perceived Benefits and Difficulties Experienced in a Mutual Support Group for Family Carers of People With Schizophrenia Qual Health Res, September 1, 2006; 16(7): 962 - 981. [Abstract] [PDF]
|
|
|
|
|
|
G. Borges, M. E. Medina-Mora, P. S. Wang, C. Lara, P. Berglund, and E. Walters Treatment and Adequacy of Treatment of Mental Disorders Among Respondents to the Mexico National Comorbidity Survey Am J Psychiatry, August 1, 2006; 163(8): 1371 - 1378. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. H. Goldman Making Progress in Mental Health Policy in Conservative Times: One Step at a Time Schizophr Bull, July 1, 2006; 32(3): 424 - 427. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. B. Gold, S. M. Glynn, and K. T. Mueser Challenges to Implementing and Sustaining Comprehensive Mental Health Service Programs Eval Health Prof, June 1, 2006; 29(2): 195 - 218. [Abstract] [PDF]
|
|
|
|
|
|
J. E. Wilk, J. C. West, D. S. Rae, and D. A. Regier Patterns of Adult Psychotherapy in Psychiatric Practice Psychiatr Serv, April 1, 2006; 57(4): 472 - 476. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Dickerson, B. Kirkpatrick, J. Boronow, C. Stallings, A. Origoni, and R. Yolken Deficit Schizophrenia: Association With Serum Antibodies to Cytomegalovirus Schizophr Bull, April 1, 2006; 32(2): 396 - 400. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. W. Roberts, T. D Warner, K. A Green Hammond, and C. M A Geppert Perspectives on Medical Research Involving Men in Schizophrenia and HIV-Related Protocols Schizophr Bull, April 1, 2006; 32(2): 360 - 365. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Turkington, D. Kingdon, and P. J. Weiden Cognitive Behavior Therapy for Schizophrenia Am J Psychiatry, March 1, 2006; 163(3): 365 - 373. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Magliano, A. Fiorillo, C. Malangone, C. De Rosa, M. Maj, and the Family Intervention Working Group Implementing Psychoeducational Interventions in Italy for Patients With Schizophrenia and Their Families Psychiatr Serv, February 1, 2006; 57(2): 266 - 269. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Addington, E. McKenzie, J. Addington, S. Patten, H. Smith, and C. Adair Performance Measures for Early Psychosis Treatment Services Psychiatr Serv, December 1, 2005; 56(12): 1570 - 1582. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Ito, A. Koyama, and T. Higuchi Polypharmacy and excessive dosing: psychiatrists' perceptions of antipsychotic drug prescription The British Journal of Psychiatry, September 1, 2005; 187(3): 243 - 247. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. Gaebel, S. Weinmann, N. Sartorius, W. Rutz, and J. S. McIntyre Schizophrenia practice guidelines: international survey and comparison The British Journal of Psychiatry, September 1, 2005; 187(3): 248 - 255. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. EDWARDS, M. G. HARRIS, and S. BAPAT Developing services for first-episode psychosis and the critical period The British Journal of Psychiatry, August 1, 2005; 187(48): s91 - s97. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. C. Kessler, P. Berglund, G. Borges, M. Nock, and P. S. Wang Trends in Suicide Ideation, Plans, Gestures, and Attempts in the United States, 1990-1992 to 2001-2003 JAMA, May 25, 2005; 293(20): 2487 - 2495. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. R. Conley, D. L. Kelly, T. J. Lambert, and R. C. Love Comparison of Clozapine Use in Maryland and in Victoria, Australia Psychiatr Serv, March 1, 2005; 56(3): 320 - 323. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. A. Rosenheck Open Forum: Effectiveness Versus Efficacy of Second-Generation Antipsychotics: Haloperidol Without Anticholinergics as a Comparator Psychiatr Serv, January 1, 2005; 56(1): 85 - 92. [Full Text] [PDF]
|
|
|
|
|
|
W.-T. Chien and S. W. C. Chan One-Year Follow-up of a Multiple-Family-Group Intervention for Chinese Families of Patients With Schizophrenia Psychiatr Serv, November 1, 2004; 55(11): 1276 - 1284. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Pappadopulos, J. C. MacIntyre II, M. L. Crismon, R. L. Findling, R. P. Malone, A. Derivan, N. Schooler, L. Sikich, L. Greenhill, S. B. Schur, et al. Treatment Recommendations for the Use of Antipsychotics for Aggressive Youth (TRAAY) Part II Focus, October 1, 2004; 2(4): 608 - 624. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Dixon The Need for Implementing Evidence-Based Practices Psychiatr Serv, October 1, 2004; 55(10): 1160 - 1161. [Full Text] [PDF]
|
|
|
|
|
|
V. J. Carr, T. J. Lewin, A. L. Neil, S. A. Halpin, and S. Holmes Premorbid, psychosocial and clinical predictors of the costs of schizophrenia and other psychoses The British Journal of Psychiatry, June 1, 2004; 184(6): 517 - 525. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Andrews, C. Issakidis, K. Sanderson, J. Corry, and H. Lapsley Utilising survey data to inform public policy: comparison of the cost-effectiveness of treatment of ten mental disorders The British Journal of Psychiatry, June 1, 2004; 184(6): 526 - 533. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Rittmannsberger, T. Pachinger, P. Keppelmuller, and J. Wancata Medication Adherence Among Psychotic Patients Before Admission to Inpatient Treatment Psychiatr Serv, February 1, 2004; 55(2): 174 - 179. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. A. Hazel, M. G. McDonell, R. A. Short, C. M. Berry, W. D. Voss, M. L. Rodgers, and D. G. Dyck Impact of Multiple-Family Groups for Outpatients With Schizophrenia on Caregivers' Distress and Resources Psychiatr Serv, January 1, 2004; 55(1): 35 - 41. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. T. Mueser, P. W. Corrigan, D. W. Hilton, B. Tanzman, A. Schaub, S. Gingerich, S. M. Essock, N. Tarrier, B. Morey, S. Vogel-Scibilia, et al. Illness Management and Recovery: A Review of the Research Focus, January 1, 2004; 2(1): 34 - 47. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Gitlin, K. Nuechterlein, K. L. Subotnik, J. Ventura, J. Mintz, D. L. Fogelson, G. Bartzokis, and M. Aravagiri Clinical Outcome Following Neuroleptic Discontinuation in Patients With Remitted Recent-Onset Schizophrenia Focus, January 1, 2004; 2(1): 122 - 130. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. RUGGERI, A. LASALVIA, M. TANSELLA, C. BONETTO, M. ABATE, G. THORNICROFT, L. ALLEVI, and P. OGNIBENE Heterogeneity of outcomes in schizophrenia: 3-year follow-up of treated prevalent cases The British Journal of Psychiatry, January 1, 2004; 184(1): 48 - 57. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. C. West, J. E. Wilk, D. S. Rae, W. E. Narrow, and D. A. Regier Economic Grand Rounds: Financial Disincentives for the Provision of Psychotherapy Psychiatr Serv, December 1, 2003; 54(12): 1582 - 1588. [Full Text] [PDF]
|
|
|
|
|
|
N. A. Dewan, D. Conley, D. Svendsen, S. P. Shon, J. R. Staup, A. L. Miller, M. L. Crismon, A. J. Rush, M. Trivedi, T. Skale, et al. A Quality Improvement Process for Implementing the Texas Algorithm for Schizophrenia in Ohio Psychiatr Serv, December 1, 2003; 54(12): 1646 - 1649. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Lenroot, J. R. Bustillo, J. Lauriello, and S. J. Keith Integration of Care: Integrated Treatment of Schizophrenia Psychiatr Serv, November 1, 2003; 54(11): 1499 - 1507. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Sohler, M. Olfson, and J. Walkup Dosages and Outcomes Psychiatr Serv, November 1, 2003; 54(11): 1547 - 1548. [Full Text] [PDF]
|
|
|
|
|
|
G. ANDREWS, K. SANDERSON, J. CORRY, C. ISSAKIDIS, and H. LAPSLEY Cost-effectiveness of current and optimal treatment for schizophrenia The British Journal of Psychiatry, November 1, 2003; 183(5): 427 - 435. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. L. Sohler, J. Walkup, D. McAlpine, C. Boyer, and M. Olfson Antipsychotic Dosage at Hospital Discharge and Outcomes Among Persons With Schizophrenia Psychiatr Serv, September 1, 2003; 54(9): 1258 - 1263. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. R. Owen, E. P. Fischer, J. E. Kirchner, C. R. Thrush, D. K. Williams, B. J. Cuffel, C. E. Elliott, and B. M. Booth Clinical Practice Variations in Prescribing Antipsychotics for Patients With Schizophrenia American Journal of Medical Quality, July 1, 2003; 18(4): 140 - 146. [Abstract] [PDF]
|
|
|
|
 |
|
 K. T. Mueser, W. C. Torrey, D. Lynde, P. Singer, and R. E. Drake Implementing Evidence-Based Practices for People with Severe Mental Illness Behav Modif, July 1, 2003; 27(3): 387 - 411. [Abstract] [PDF]
|
|
|
|
 |
|
 W. A. Ray, J. R. Daugherty, and K. G. Meador Effect of a Mental Health "Carve-Out" Program on the Continuity of Antipsychotic Therapy N. Engl. J. Med., May 8, 2003; 348(19): 1885 - 1894. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. J. Sernyak, D. Dausey, R. Desai, and R. Rosenheck Prescribers' Nonadherence to Treatment Guidelines for Schizophrenia When Prescribing Neuroleptics Psychiatr Serv, February 1, 2003; 54(2): 246 - 248. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. T. Mueser, P. W. Corrigan, D. W. Hilton, B. Tanzman, A. Schaub, S. Gingerich, S. M. Essock, N. Tarrier, B. Morey, S. Vogel-Scibilia, et al. Illness Management and Recovery: A Review of the Research Psychiatr Serv, October 1, 2002; 53(10): 1272 - 1284. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. D. Webster, S. J. Hucker, and H. Bloom Transcending the Actuarial Versus Clinical Polemic in Assessing Risk for Violence Criminal Justice and Behavior, October 1, 2002; 29(5): 659 - 665. [Abstract] [PDF]
|
|
|
|
|
|
K. A. Comtois A Review of Interventions to Reduce the Prevalence of Parasuicide Psychiatr Serv, September 1, 2002; 53(9): 1138 - 1144. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. O'Hare, T. V. Tran, and P. Collins Validating the Internal Structure of the Practice Skills Inventory Research on Social Work Practice, September 1, 2002; 12(5): 653 - 668. [Abstract] [PDF]
|
|
|
|
|
|
A. Torres, L. P. Mendez, H. Merino, and E. A. Moran Rehab Rounds: Improving Social Functioning in Schizophrenia by Playing the Train Game Psychiatr Serv, July 1, 2002; 53(7): 799 - 801. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. K. Milner and M. Valenstein A Comparison of Guidelines for the Treatment of Schizophrenia Psychiatr Serv, July 1, 2002; 53(7): 888 - 890. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. P. Fischer, M. Shumway, and R. R. Owen Priorities of Consumers, Providers, and Family Members in the Treatment of Schizophrenia Psychiatr Serv, June 1, 2002; 53(6): 724 - 729. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. G. Dyck, M. S. Hendryx, R. A. Short, W. D. Voss, and W. R. McFarlane Service Use Among Patients With Schizophrenia in Psychoeducational Multiple-Family Group Treatment Psychiatr Serv, June 1, 2002; 53(6): 749 - 754. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. P. Hayhurst, P. Brown, and S. W. Lewis The cost-effectiveness of clozapine: a controlled, population-based, mirror-image study J Psychopharmacol, March 1, 2002; 16(2): 169 - 175. [Abstract] [PDF]
|
|
|
|
|
|
D. E. Biegel, J. A. Johnsen, and R. Shafran The Cuyahoga County Community Mental Health Research Institute: An Academic-Public Mental Health Research Partnership Research on Social Work Practice, May 1, 2001; 11(3): 390 - 403. [Abstract] [PDF]
|
|
|
|
 |
|
 I. D. Glick, T. Suppes, C. DeBattista, R. J. Hu, and S. Marder Psychopharmacologic Treatment Strategies for Depression, Bipolar Disorder, and Schizophrenia Ann Intern Med, January 2, 2001; 134(1): 47 - 60. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. T. Marsh Serious Mental Illness: Opportunities for Family Practitioners The Family Journal, October 1, 1999; 7(4): 358 - 366. [Abstract] [PDF]
|
|
|
|
 |
|
 Commentary On "Enabled To Care": the State We'Re in International Journal of Social Psychiatry, September 1, 1999; 45(3): 159 - 161. [PDF]
|
|
|
|
 |
|
 G. R. Bond, R. E. Drake, D. R. Becker, and K. T. Mueser Effectiveness of Psychiatric Rehabilitation Approaches for Employment of People with Severe Mental Illness Journal of Disability Policy Studies, January 1, 1999; 10(1): 18 - 52. [Abstract] [PDF]
|
|