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Schizophrenia

- Summary
- About schizophrenia
- Myths and misperceptions
- Types and differences
- Risk factors and causes
- Signs and symptoms
- Diagnosis methods
- Treatment options
- Ongoing research
- Questions for your doctor

Reviewed By:
Andrea Bradford, M.D., M.M.M.
Tahir Tellioglu, M.D., APA, AAAP

Treatment options for schizophrenia

The cause of schizophrenia is largely unknown, and there is no known way to prevent or cure the disorder. The focus of treatment is often to control symptoms with minimal side effects from medication, and achieve the best recovery possible.

Patients are usually treated at home. However, they can be treated in a hospital if they experience acute symptoms, such as severe delusions or hallucinations, serious suicidal thoughts, an inability to care for themselves or if they are violent or threatening others as a result of their illness.

The most common treatment for schizophrenia is antipsychotic medication. Patients with schizophrenia sometimes stop taking medications because they feel better, forget to take them or dislike the side effects, or take them sporadically because they think regular use is not important. Following the physician's directions for medications and communicating any problems to the physician is the most important thing to make sure there is adequate treatment.

In addition to medication, patients with schizophrenia may need psychosocial rehabilitation (therapy that involves addressing both social and psychological behavior). Research has shown that patients treated with rehabilitation and medication are best able to manage their illness.

Psychosocial treatment may include therapy to address substance abuse (common in people with schizophrenia), social and vocational training to help people work and live in the community, occupational therapy to increase independence with activities of daily living such as grooming and meal preparation and job skills, and illness management techniques to help patients understand their condition, identify signs of relapse and develop a plan in case relapse occurs.

It is very important that the therapy the person gets is appropriate for that individual's needs. Some people are more disabled than others and need more basic therapy and vocational training. Others are well controlled on their medication and not only do not benefit from basic training and therapy, but can become very frustrated if they are "required" to participate and stop all of their treatments. Treatment should always be individualized to the needs of the person.

Cognitive behavior therapy may be helpful for patients whose symptoms continue even with medication. Cognitive therapists teach patients how to monitor the reality of their thoughts and perceptions, how to ignore auditory hallucinations and how to cope with apathy that can be immobilizing.

Self-help groups can provide comfort and support among members who share their experiences. Networking in groups can also generate social action when members unite and advocate for more research or treatment programs.

Studies show that after 10 years of treatment, 25 percent of patients recover completely, 25 percent improve a great deal and 25 percent experience some improvement. Fifteen percent of patients do not experience improvement and 10 percent die, usually by suicide or accident, according to National Alliance for the Mentally Ill (NAMI).

Schizophrenic people have a higher risk of suicide than the population at large. Threats of suicide or any activity that you think might be a suicide attempt or planning for suicide should be taken very seriously and evaluated by a professional.

People with schizophrenia often resist treatment because they believe that their hallucinations and delusions are real and that they do not need psychiatric help. Although laws differ from state to state, civil rights laws to protect patients with schizophrenia from being involuntarily committed into a mental health facility have become strict. If patients pose a danger to themselves or others and refuse to seek treatment, family members may have to call the police to transport the patient to the hospital. Once at the hospital, the patient will be evaluated by a mental health professional.

Patients with schizophrenia often need assistance from family members, friends and others to ensure that they continue to receive treatment and take their medications. Schizophrenia is a chronic disease. If patients stop taking medications, psychotic symptoms can reappear and may impair their ability to care for basic needs, such as food, clothing and shelter. Family and friends can also help patients set realistic goals for coping with their illness. It is important to show support and encouragement because patients who feel pressured or criticized often regress, making symptoms worse.

In very rare cases, electroconvulsive therapy (ECT) may be recommended by a psychiatrist to treat certain symptoms of schizophrenia. ECT is particularly useful for people with schizophrenia who have bad catatonic symptoms or hallucinations that do not respond to any medications and are life threatening. Most frequently, ECT is used for other psychiatric disorders.

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Review Date: 07-17-2008
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