What Are The Most Effective Treatments For Schizophrenia?
Schizophrenia is considered a serious mental disorder that affects the patient’s functionality and quality of life in different areas.
In the face of this pathology, different treatments have been used and tested to improve the life of the affected subject. Pharmacological treatment with antipsychotics has been especially useful during the acute phase of the disease, when the symptoms are more intense. Likewise, it also serves as maintenance treatment, reducing the number of relapses.
But it has been observed that it is necessary to complete the treatment with psychosocial therapy, to achieve a better adaptation of the patient to daily life, help reduce symptoms, improve adherence to treatment and prevent and reduce the number of relapses.
In this article we will present the most effective treatments for schizophrenia and which are considered more recommended.
Schizophrenia is classified within the group of psychotic disorders, being considered a serious disorder, causing the person suffering from it to perceive or interpret reality in an abnormal way.
The diagnostic manual of the 5th edition of the American Psychological Association requires the diagnosis of schizophrenia to meet two or more of the following symptoms: delusional ideas, hallucinations, disorganized language, disorganized or catatonic behavior or negative symptoms.
These alterations must be present for at least 1 month and the signs of the disease must last for at least 6 months, including this period the prodromal symptoms, prior to the episode, the psychotic episode and residual symptoms.
In this way, we verify that The characteristic symptoms of schizophrenia can be divided into two groups.: positive ones, defined as symptoms of excess (new sensations, beliefs appear…); and negative ones, default symptoms that lead to a decrease in a behavioral pattern (the patient is less active, his activity decreases).
Having defined what we understand by schizophrenia, let’s see what treatments exist and which of them are most effective.
The most effective treatments to intervene in patients with schizophrenia
Given the severity and tendency toward chronicity of this disorder, many different treatments have appeared and been tested. Even so, not all have shown the same effectiveness since it will also depend on the characteristics of each patient and the phase of the disease in which they are found.
In the acute phase of the disease, it has been seen to be more effective to protect the patient, trying to reduce overstimulation and possible damage.in this phase it can be difficult to carry out psychological therapies, such as cognitive behavioral therapy.
After 6 or 24 months of the acute crisis of the disease, when it is in the stable phase, skills training, rehabilitation and psychological treatment will be much more productive, and the patient will be more prepared.
The treatment of choice for patients with schizophrenia, that is, the most used, has been pharmacological, but it has been observed that this treatment does not improve all symptoms in the same way, producing very limited improvements in negative symptoms.
Thus, It is understood as necessary to include and carry out a joint treatment with psychological therapyto improve symptoms that do not decrease with medication and to increase patient adherence to treatment, since 75% of patients have irregular adherence to drugs.
Pharmacotherapy is considered an effective treatment for schizophrenia. The most used psychotropic drugs are antipsychotics, the first to be used were the typical neuroleptics such as haloperidol and chlorpromazine, these only produced improvement in the positive symptoms and could even worsen the negative ones. In this way, atypical antipsychotics appeared that, apart from reducing positive symptoms, also improve negative ones and generate fewer side effects than the previous ones. Of these new antipsychotics we can name clozapine and quetiapine.
Also as a biological treatment, with drugs, the neuroleptic depot is used.; The medication is injected intramuscularly, allowing the release of the product for a period of between 2 and 4 weeks. This mode of treatment has been seen to be effective in patients with low adherence or who find it difficult to self-administer the neuroleptic regularly, adequately complying with the treatment.
As already mentioned, it is advisable to carry out psychological treatment in addition to pharmacological treatment. It has been proven that those that are most effective are assertive community treatment, social skills training, integrated multimodal packages, and protected employment procedures for vocational rehabilitation. So, let’s see which are the most effective psychological treatments in cases of schizophreia.
The assertive community treatment of Arnold Marx, Leonard Stein and Mary Ann Test The main objectives are that the patient remains linked to community mental health services and that a reduction in the number and duration of hospital admissions is achieved..
It is a specific treatment for serious mental disorders where a multidisciplinary team (psychologists, doctors, nurses…) share the responsibility of the treatment and continuously take care of the patient’s care. Being a team made up of various professionals allows us to cover all care in an integrated and intensive way.
As we have already mentioned, the entry of the subject is avoided, therefore the place of treatment will be the community (the street, the home, the work…) in the real places where the affected person lives, in order to be able to work in the natural social system. . In the same way, the treatment is individualized, this means that it will be adapted to the abilities, qualities and strengths of each patient.
The individualized intervention carried out in the natural environment where the patient lives predisposes the treatment to be flexible, that is, that adapts to the needs of the moment, not only those specific to the disorder but also all those that may arise in the individual’s daily life.. Given this need to improve various aspects of the patient’s life and be able to intervene at any time, coverage and care will be 24 hours a day.
We will try to make quick interventions, carrying out close subsequent monitoring, ensuring that the treatment continues to be completed and the improvements remain present, to be able to go and intervene when a possible risk of abandonment or decompensation is detected. In this way, contact with the patient will be continuous and unlimited, decreasing the intensity as the individual improves but maintaining close contact to support any needs that may arise.
2. Social skills training
Training in social skills is essential in patients with schizophrenia given their functional impairment in the social sphere. So that this improvement and treatment can be generalized, it is proposed to work on non-verbal skills, paralinguistic characteristics, verbal content, interactive balance and social perception.
Psychiatrist Robert Liberman proposes a social skills program for independent livingpresenting the following modules: medication management, symptom self-management, community reintegration, leisure and free time, conversation skills, substance abuse management, work skills, intimate interpersonal relationships and social skills.
Liberman pointed out that despite the moderate capacity of schizophrenic patients to generalize the learning of social skills, and the difficulty in learning these on the part of subjects with severe symptoms, individuals who received training in social skills consistently reported of a decrease in social anxiety.
3. Integrated multimodal packages
The integrated multimodal packages of Volker Roder, Hans Dieter Brenner and Bettina Hodel They are a behaviorally oriented group treatment divided into 5 hierarchically ordered subprogramseach subprogram will deal with difficulties at different levels, these levels being related to each other.
The intervention, as noted, proceeds hierarchically, first at the lower levels and then being able to focus on more complex aspects. The improvements produced with this treatment are observed in both cognitive and social functioning.
The subprograms that work and treat this therapy are the following: cognitive differentiation, related to attention skills and concept formation; of social perception; of verbal communication; social skills and interpersonal problem solving.
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4. Protected employment for labor rehabilitation
With the aim that patients with schizophrenia achieve integration into the workplace, supported and adapted work programs are recommendedsince it has been observed that it is one of the psychosocial treatments whose effectiveness for the disorder has experimental support, likewise, it has obtained better results compared to the rest of the work rehabilitation interventions.
Related article: “Psychoeducation in psychological therapy”
5. Other treatments also recommended
Cognitive-behavioral therapies such as Paul Chadwick’s cognitive therapywith the purpose of modifying beliefs using mainly verbal challenge and reality testing, have been considered probably effective, especially improving positive symptoms, such as delusions and hallucinations and improving adherence to treatment and reducing relapses.
Similarly, psychoeducational intervention is also recommended for patients and their families, so that they know the disease better and are more willing to collaborate in its treatment.
