Guideline for the Treatment of Patients With Schizophrenia

Schizophrenia is a chronic debilitating brain disorder. The National Institute of Mental Health states that schizophrenia annually affects approximately 1.1 percent of the American population over 18 years old. Symptoms include hallucinations, social withdrawal, delusions, movement disabilities and an incoherent thought process. The treatment of schizophrenia involves various stages.

Acute Phase

• When a patient undergoes an acute psychotic episode, the acute phase treatment strives to prevent harm, curb the disturbing behavior, and lower the seriousness of the psychosis and symptoms. Additionally, it addresses the issue causing the episode, induces quick return to the most effective level of functionality, and creates a meaningful connection between patient and family.

  The patient is advised to undergo a thorough clinical examination, including a comprehensive overview of his psychiatric and medical history. Unless he decides against it, individuals knowledgeable about his condition must be interviewed regularly. Often, the most frequent reasons for acute psychotic relapses are refusal to adhere to the prescribed anti-psychotic medication, drug abuse and stress. However, a relapse can naturally occur even if treatment is ongoing. If non-adherence to the medication is to blame for a relapse, the cause should be considered and incorporated into the treatment plan.

  Provided there are no serious side effects, medication should be given to the patient promptly. Before prescribing medication, the psychiatrist must consider the patient's prior relationship with antipsychotic drugs. Most schizophrenics prefer oral treatment; however, for those with recurring relapses, a long-lasting antipsychotic injection is appropriate.

Stabilization Phase

• The stabilization phase aims to lower the patient's stress level, while providing supportive methods of reducing the likelihood of a relapse. It also helps the patient to adapt to her community, promotes recovery and keeps her symptoms under control. If she shows progress in a certain area, the strategy used should be continued for at least six months. Stopping medication or lowering the dosage prematurely during this stage can cause a relapse and a rebirth of symptoms. Side effects that were present in the acute stage must be continuously evaluated and medications must be adjusted to reduce side effects. There should be no treatment gaps because patients susceptible to a relapse after an acute episode require support to function capably in their normal life and in their community.

Stable Phase

• The stable phase seeks to keep the patient's symptoms sustained, and is also concerned with the patient improving his societal functionality and quality of life. It strives to ensure that symptoms and relapses are properly treated and that monitoring for treatment side effects continues. With the patient's approval, close ties should be maintained with those in the patient's inner circle--individuals who are close enough to see emerging symptoms or situations that may result in a relapse or hinder the patient's functionality.

Treatment Settings

• Hospitalization is generally recommended when the patient is considered a threat to herself or others, and requires continuous support and supervision. If it is uncertain if she needs to be hospitalized, alternative community-based treatments, such as day hospitalization, should be considered. Day treatment programs have no time limits and are used to provide long-term support to the marginally adjusted schizophrenic.