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Schizophrenia - Comprehensive Case Management.

What is the optimal treatment program for schizophrenia?

While there is not yet a definitive answer to this question, it seems clear that the preferred treatment includes both medication & interventions based on several psychosocial perspectives. Efforts to improve the patient's skills , to educate the patient & family members about schizophrenia, to provide family support, and to provide a social safety are important for all patients, especially many individuals with a chronic form of the disorder & their families are all important in assuring the best possible outcome.

Unfortunately, such treatment combinations are very rare. However, even relatively simple family interventions, as well as more comprehensive community treatment programs, have been shown to be effective for preventing relapse & reducing the " revolving door syndrome". In this syndrome, the affected person shuttles back & forth between living in the community & hospitalization, & experiences little coordination in treatment from different agencies & other service providers. The symptoms of a schizable group of patients are not helped by medication, so for them the psychosocial treatment approach is even more important.

Most studies of treatment outcome focus on a lessening of symptoms. Although this is certainly important, psychosocial adjustment, particularly between relapses, is also of great importance. For people living independently of their families, psychological therapies combined with medication have been shown to improve work performence & relationships with others. Among patients living with their families, those who received psychologically based therapy were more competent & interpersonally effective. Lasting effect of these changes ia also important. While changes based on medication tended to last a year or less after hospitalization, changes associated with intensive psychosocial treatment combined with medication were still apparent after several years.

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