Schizophrenia is a disorder of thought and perception. Disorders of thought such as delusions ( false beleifs that are held with conviction ) and disorders of perception such as hallucinations ( seeing or hearing things that others cannot ). In addition to this, schizophrenia is associated with behavioral disturbances and a deteroration in mental ability ( things like memory, attention, concentration, judgement). For a brief introduction on schizophrenia and other psychoses click here.
The treatment of schizophrenia usually involves 3 phases.
The Acute Phase - At first visit, a diagnosis of schizophrenia is first confirmed based on symptoms. Investigations are ordered in order to assess the patients baseline state and to rule out other conditions that can mimic schizophrenia.Treatment is then initiated with antipsychotics (drugs that help reduce delusions,hallucinations and behavioral issues). A drug with the best risk vs benefit ratio for that particular patient will be chosen. Over the next few weeks as symptoms begin to diminish, patients move to a maintanence phase. Here, the prime objective is to optimize drug doses and to prevent the reoccurance of symptoms.
During and post the maintanence phase, the focus shifts to rehabilitation. We work on reintroducing the patient back into a productive enviroment. A number of people may maintain well, while others will have distressing deficits which need further management. As an unspoken rule upto 2/3 rd of people may continue to experience problems.
Cognitive disturbances may be addressed via cognitive retraining exercises, social skills may need to be reintroduced. Cognitive behavioral therapy for psychosis may be administered once symptoms have begun to reduce with the aim of improving insight.
Here are the treatment options..
1) Medications (Antipsychotics) are first in line in term of treating schizophrenia. A wide range of therapeutic options are currently available.
2)Psychotheray as an adjunct to medication. Cognitive behavioral therapy for psychosis, art therapy, supportive psychotherapy and client centered psychotherapy may be helpful in improving functioning to a great extent.
3)Cognitive remediation, including occupational retraining
Treatment of schizophrenia does not end at curing symptoms. The goal of treatment is to recover from illness and restore social and occupational functioning. With enough effort from the patient and the practioners, and a holistic approach, schiophrenia can be optimally managed.
Schizophrenia is chronic, distressing and is a huge burden on the caretakers of those affected. Ideally the caretakers should a
Psychiatry is a medical speciality, like surgery, general medicine and paediatrics. It involves the study, diagnosis and management of mental illnesses and distressing conditons, pertaining to both the mind and body. Misconceptions about psychiatric illness and treatment have some how prevented help seeking behaviour in those who need it the most. This Wall has to go, wherin visiting a psychiatrist should no longer be taboo, and people should be able to openly and freely discuss mental health issues. More here.
Dr Vikas Prabhav is a psychiatrist in Anna nagar, chennai. He runs The Vivid Mind mental wellness clinic in Anna Nagar. We aim at providing holistic, multimodal care for those suffering from mental illnesses and adjustment issues. We offer effective management strategies for depression, anxiety, unexplained physical symptoms, addictions, child/adolescent problems and other behavioural issues.The information provided in this website does not substitute for a medical consult.