Eligibility of participants
pervasive mental disorder or, posturing, psychotic disorder, substance dependence, schizophrenia, schizophreniform disorder, schizophrenia-spectrum, bipolar disorder, cognitive sequelae, psychiatric, hallucination, schizophrenia, DSM-5
POSTURING
Stable male and female outpatients or patients at psychiatric daycare service, age 18–60 years old, with a diagnosis of schizophrenia, schizophreniform disorder, or other schizophrenia-spectrum and other psychotic disorder based on the DSM-5 criteria, currently receiving antipsychotic treatment at a fixed dose for at least 3 months (including long-acting injectable antipsychotic), currently having PANSS positive and general symptom score ⩽ 3 in P1: delusion, P2: conceptual disorganization, P3: hallucination, G9: unusual thought, G5: mannerism and posturing, and negative symptom score ⩽ 4 in N1: blunted affect, N4: social withdrawal, N6: lack of spontaneity/flow in conversation for at least 3 months, with no revised use of benzodiazepines, antidepressants, anticholinergics, or other concomitant medications during the past 3 months and a second antipsychotic agent only used for a low-dose, as needed adjuvant purpose were eligible to participate in this trial.Patients with a score ⩾ 5 on any of the 30 PANSS rating items at screening, admission to the acute psychiatric unit during the past 6 months, a change in dose of current antipsychotic medication in recent 3 months, concomitant use of mood stabilizers, such as lithium, valproic acid, or other anti-epileptic drugs, IQ below 70 prior to the diagnosis of schizophrenia, a history of pervasive mental disorder or bipolar disorder, a medical condition with significant cognitive sequelae, a history of substance dependence during the past 6 months, or currently in pregnancy or breastfeeding were not eligible to this trial.Eligible patients were briefed with a psychoeducation session regarding the possible risk and benefit of long-term antipsychotic treatment and the rationale of this GDR trial before obtaining their written informed consent. Patients younger than the age of 20 years old needed to provide written consent from their parents in accordance to Taiwan's law.