Successfully Treating Schizophrenia

schizophreniaSchizophrenia is a chronic and severe, disabling brain disorder that affects approximately 1.1 percent of the population.[1] Schizophrenia distorts the way a person thinks, acts, expresses emotion, perceives reality, and relates to others.1 This disorder requires long-term treatment, with medicine being the cornerstone.1 However, Dean of the Medical College of Georgia at Georgia Regents University, Peter Buckley, MD, believes a comprehensive plan, including familial support and education, and considers the person’s individual psychological needs is essential.1 However, the treatment specifics depend upon the stage of the illness and the person’s age.1

“Someone who is having a first episode of psychosis might have a different treatment plan than someone who is 45 and has been ill for many years,” said Director of the Maryland Psychiatric Research Center and leading expert in schizophrenia, Robert Buchanan, MD.1

Learning about schizophrenia and its symptoms is the most effective way to treat the illness for the person.1 They should focus on their important life goals, take their medicine as prescribed, learn to manage stress and symptoms, avoid substance abuse, develop a relapse plan, and build a social support network.1

As schizophrenia is a lifelong illness, it requires lifelong medication management.1 Unfortunately, finding the right medicine for each individual is a trial-and-error process.1 There are no predictors to tell which drug will be effective for who.1 One the correct medicine is found, adhering to it is the next challenge.1 In fact, approximately 74 percent of patients stop taking their medicine within the first 18 months of treatment, and this increases their risk of relapse, hospitalization, and suicidal behavior.1 Also, the reason each individual stops taking their medication is different.1 The most common is the lack of awareness of being ill.1 Other reasons are bothersome side effects, the disapproval of family members, and others’ bad experiences with the medicines.1

However, a solid relationship between the prescribing doctor and the patient can enhance adherence.1 Many patients don’t feel involved in the decision-making when choosing a medicine, feeling ordered to take it.1 Open discussions help the patient feel more comfortable with taking medicine.1 Also, cognitive impairment leads to forgetting to take medicine, so incorporating their medication schedule into their daily routine is important.1 For example, placing their pills next to their toothbrush or using organizers or alarms can be helpful.1 If this doesn’t work, offering long-term injectable medicine allows for patients to not have to remember a daily dose, only a bi-weekly or monthly appointment.1

Psychosocial interventions are also important, said Buckley.1 “Psychosocial interventions are a cornerstone of the comprehensive treatment of patients with schizophrenia, and when used in combination with medication, they are more effective than antipsychotics alone,” he said.1

One of the most effective intervention for those with schizophrenia is cognitive-behavioral therapy (CBT).1 This therapy treats the positive symptoms of schizophrenia, such as hallucinations and delusions, as well as the negative symptoms, such as lack of motivation.1 Individuals learn to identify recovery goals and work towards them.1

Also, educating families of patients about schizophrenia is the best way to offer social support.1 This can benefit the patient by helping to increase medication adherence and decrease relapse rates.1

Other interventions include social skills training, which helps individuals to be assertive, resolve conflict, and navigate work issues.1 Supported employment is also important, as it helps patients find and keep jobs in the community, based on their abilities and preferences.1 Buchanan said, “This includes individually tailored job development, rapid job search, availability of ongoing job supports, and integration of vocational and mental health services.” It also helps build self-esteem and self-image.1

Researchers are also working on a behavioral training-based intervention that helps improve cognitive processes, such as attention, memory, and executive function.1 These are the most damaging symptoms for a patient’s work, education, and independent life.1 Most programs currently use computers to target one or more cognitive skills, strengthening them.1

Psychosocial interventions, medication adherence, and family education are all critical factors of treating schizophrenia successfully.1

[1] Tartakovsky, M. (2014). Treating Schizophrenia Successfully. Psych Central. Retrieved on March 17, 2014, from http://psychcentral.com/lib/treating-schizophrenia-successfully/00018927

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