This is a 12-month open-label randomized controlled study. Patients with schizophrenia and violence risk under the government supervision will be enrolled in the study. A community-based long-acting antipsychotics-treated management model will be applied to the experimental group, which means that professional psychiatrists will provide guidance to primary-level mental health workers on the psychotic treatment, and monthly-injected long-acting antipsychotic, paliperidone palmitate, will be used in the schizophrenia treatment. Every subject in experimental group will be equipped with an intelligent robot capable at push-to-talk and push-to-view, allowing the patients and caregivers to contact doctors for assistance at any time. The subjects in experimental group will be injected with 150mg eq and 100mg eq paliperidone palmitate in the deltoid at the 1st and 8th day, and afterwards a flexible dose of paliperidone palmitate from 75 to 150mg eq will be administrated monthly according to clinical judgement. Subjects in control group will be treated with oral antipsychotics or other conventional medication.
This is a 12-month open-label randomized controlled study. Patients with schizophrenia and violence risk under the government supervision will be enrolled in the study. A community-based long-acting antipsychotics-treated management model will be applied to the experimental group, which means that professional psychiatrists will provide guidance to primary-level mental health workers on the psychotic treatment, and monthly-injected long-acting antipsychotic, paliperidone palmitate, will be used in the schizophrenia treatment. Every subject in experimental group will be equipped with an intelligent robot capable at push-to-talk and push-to-view, allowing the patients and caregivers to contact doctors for assistance at any time, if they are able to use smart phones. The subjects in experimental group will be injected with 150mg eq and 100mg eq paliperidone palmitate in the deltoid at the 1st and 8th day, and afterwards a flexible dose of paliperidone palmitate from 75 to 150mg eq will be administrated monthly according to clinical judgement. Previous oral antipsychotics could be continued or withdrawn in 2-4 weeks after first paliperidone palmitate administration according to doctors' clinical judgement. Doctors have rights to decide whether a patient needs in-hospital treatment or extramural hospital treatment. The study protocol does not limit other medication or treatment measures except the injectable paliperidone palmitate. Other medication or treatment measures should be decided according to doctors' clinical judgement and negotiation with patients and guardians. Subjects in control group will be treated with oral antipsychotics or other conventional medication.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
150
Subjects in experimental group will be injected with 150mg eq and 100mg eq paliperidone palmitate in the deltoid at the 1st and 8th day, and afterwards a flexible dose of paliperidone palmitate from 75 to 150mg eq will be administrated monthly according to clinical judgement. Previous oral antipsychotics could be continued or withdrawn in 2-4 weeks after first paliperidone palmitate administration according to doctors' clinical judgement.
Subject in control group will be applied with oral antipsychotics or other conventional medication.
Violence Risk Assessment For Severe Psychiatric Patients
The percentage of subjects rated as no or low risk (scored 0 or 1) in Violence Risk Assessment For Severe Psychiatric Patients after 1-year treatment
Time frame: 1 year
Modified Overt Aggression Scale (MOAS)
Patients' rated score in Modified Overt Aggression Scale after 1-year treatment
Time frame: 1 year
Health economic evaluation
The patients' and the caregivers' health economic questionnaire after 1-year treatment
Time frame: 1 year
Positive and Negative Syndrome Scale (PANSS)
PANSS total score after 6-month and 1-year treatment
Time frame: 1 year
Hospitalization frequency
Hospitalization frequency after 6-month and 1-year treatment
Time frame: 1 year
WHO Quality of Life-BREF (WHOQOL-BREF)
The patients' and the caregivers' WHOQOL-BREF score after 6-month and 1-year treatment
Time frame: 1 year
Visual Analogue Scale-100 (VAS 100)
The patients' and the caregivers' VAS 100 score after 6-month and 1-year treatment
Time frame: 1 year
Family Burden Scale of Diseases (FBS)
Family burden of the patient's family
Time frame: 1 year
Personal and Social Performance Scale (PSP)
PSP global score after 6-month and 1-year treatment
Time frame: 1 year
Treatment Emergent Symptom Scale (TESS)
Treatment Emergent Symptom Scale (TESS) score after 6-month and 1-year treatment
Time frame: 1 year
Vital signs
Heart rate and blood pressure after 6-month and 1-year treatment
Time frame: 1 year
Clinical laboratory examination
Blood routine examination after 6-month and 1-year treatment
Time frame: 1 year
Electrocardiogram (ECG)
Electrocardiogram (ECG) after 6-month and 1-year treatment
Time frame: 1 year
Adverse events
The frequency of adverse events in the treatment period
Time frame: 1 year
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