Best Treatment for Persons Diagnosed with Schizophrenia - Research Paper Example

? Schizophrenia The best treatment approach for improving the quality of life of persons diagnosed with Schizophrenia Institution/College Month and Year submitted Abstract Schizophrenics are a group of mentally ill patients who lived a life of very poor quality. Basic rights were denied these patients due to their ignorance. With the combination of symptoms they had, they led a terrible life of dependence. The symptoms like hallucinations and delusions isolated them from the others in society. Unable to care for themselves in many ways, they were devoid of social relationships. They also were incapable of winning people over or keeping their jobs because of their odd behavior, poor memory and inattention. Every day of their lives, they were on therapy. This writer will be investigating various researches to find a possible solution to the plight of the schizophrenics. The aim is to improve the quality of life of the schizophrenic patients. The best treatment approach for improving the quality of life of persons diagnosed with Schizophrenia Introduction Schizophrenia was a mental health disorder with several symptoms: positive and negative (Draper et al, 2009). Diagnosis was made by the DSM-IV criteria. Hallucinations represented the positive symptoms. The negative symptoms were the emotional problems of flat affect (Arif et al, 2011). Cognitive deficits included attention problems. This writer will investigate the efficacy of the types of therapy that had been used for management of schizophrenics and the advantages of using cognitive behavior therapy and rehabilitation in addition assuming that the combination of procedures would elevate the quality of life of schizophrenics. CATIE The CATIE (Clinical Antipsychotic Trials of Intervention Effectiveness) was performed in US with 1460 patients to unearth evidence to indicate how clinical management could improve the efficiency of management (Bick et al, 2007). Different atypical antipsychotic drugs were investigated in clinical practice for an 18 month period (Bick et al, 2007). A 3-phase design was used. The results were depressing in that the drawbacks of the clinical practice were found. Antipsychotic treatment alterations The second generation drugs of olanzapine and clozapine which were the usual first-line- of- treatment drugs and widely used had the problems of metabolic dysfunction. Responding to the need for improvement of treatment of schizophrenia, newer drugs had been studied recently. This paper will highlight a few recent studies out of the many. The goal of antipsychotic treatment was to eliminate symptoms rapidly, prevent the relapses, decrease the severity of the illness and help to improve social relationships (Chwieduk and Keating, 2010). The use of Iloperidone, Paliperidone and Lurasidone were investigated (Arif and Mitchell, 2011; (Chwieduk and Keating, 2010; Ehret et al, 2010). Cognitive behavior therapy Cognitive behavior therapy (CBT) had been recognized by many researchers as appropriate for treating schizophrenic patients as a complement to their pharmacotherapy (Kuller et al, 2010). The collaborative efforts of the clinician and the patient in evaluation of delusional beliefs in order to understand the underlying beliefs constituted one approach. The success of the therapy depended on the extent of therapeutic relationship between the clinician and the patient. Almost 20 trials had compared the treatment of patients who had the usual therapy of drugs and case management as against another group which had CBT in addition. The outcomes were based on patient characteristics, acute against chronic illness, short against long-term results and the type of symptoms. Psychosocial rehabilitation Valencia et al investigated the possibility of implementing a rehabilitation program in Mexico on the lines of similar programs in the US and the UK (2010). Social skills training and family psycho-education both established rapport between them (Valencia, 2010). The patients became less anxious and the program was a success. Primary topic Management of schizophrenia was a major problem in psychiatry. The severely affected psychological functioning in these patients warranted antipsychotic medication and case management based on the patient’s co-morbidity requirements (Kuller et al, 2010). Schizophrenic patients experienced their symptoms life-long. They had secondary morbidity in the form of depression or anxiety. The best outcome required more than antipsychotics (Kuller et al, 2010). This researcher will be investigating the question: 1. Did the usual management of schizophrenics increase the quality of their lives? Secondary topic The secondary morbidity of schizophrenics with depression, anxiety and social dysfunction also needed to be addressed for the management to be complete. The identification of psychotherapeutic strategies to complement the pharmacotherapy had become important in the light of the poor quality of the lives of schizophrenics. This paper will also address the use of other methods to improve the life of schizophrenics along with the usual treatment. 2. How can we improve the quality of life of schizophrenics? Why it is important to study Schizophrenics had a poor quality of life and had cognitive deficits and mental health problems which impeded their normal social interactions creating problems at home and in their workplaces. My aim will be to investigate ways of management to relieve their burdensome lives sufficiently so as to enable them to live a better life with socialization and gain the capacity to continue confidently at their work-places. This would also reduce the burden on their families or friends who tended to them. Research questions: 1. Had the usual management of schizophrenics, who had treatment with drugs and case management, increased the quality of their lives? 2. How can we improve the quality of life of schizophrenics? Method A comprehensive review of the available research regarding the management of schizophrenia revealed many aspects of management by other researchers. The searches were performed using the terms “management of schizophrenia”, “schizophrenia”, “pharmacotherapy for schizophrenia” and “psychotherapy for schizophrenia” and “rehabilitation of schizophrenia”. The abundance of research allowed me to select recent articles mostly limited within the last five years and focused on the different aspects for the management. Results and findings The search for literature provided me many articles from Cinahl Plus and PsychInfo journals in Ebscohost. The search was limited to peer-reviewed full text recent literature from the year 2005 onwards. The CATIE results provided abundant information on what actually happened in clinical practice (Bick et al, 2007). The assumption was that newer drugs did not produce an impact as expected (Bick et al, 2007). It was not the alteration of management that was found necessary but the effective implementation by psychiatrists and the management of the patients as a whole. The review by Arif and Mitchell (2011) found that the symptoms of schizophrenia were improved by Iloperidone. Paliperidone with extended release was useful to control both the positive and negative symptoms (Chwieduk and Keating, 2010). Lurasidone was found to control the schizophrenia in outpatients and inpatients (Ehret et al, 2010). Kuller et al indicated that improvements of treatment were usually positive with CBT rather than the usual treatment with drugs (2010). Future trials needed to include more clinicians from a larger area in the US. Random sampling techniques with larger samples and different patient features would provide better results about the efficacy of CBT. The cohort study of Valencia showed the decrease of symptoms in both groups with the treatment (2010). The reduction in the psychiatric symptoms, the lesser relapses and less frequent re-hospitalization spoke in favor of psychosocial rehabilitation (Valencia et al, 2010). The answer to the first research question is “no, the quality of life of schizophrenics whether treated or not is low”. To the 2nd research question: “several factors for improvement or alteration of the quality of life have been identified in the process of this investigation”. If all those factors could be combined, the quality of life of schizophrenics would soar. Discussion and Conclusions The various factors identified for raising the quality of life of the schizophrenics included proper pharmacotherapy with an appropriate drug, the intensified treatment of acute phases and relapses with newer drugs, treatment of all health conditions together, cognitive behavior therapy and the psychosocial rehabilitation to bring them back to normal life. Schizophrenics had to have proper management of their illness. If they had other illnesses along with schizophrenia, they had to be treated simultaneously for those (Bick et al, 2007). Policy makers had to find ways to solicit the compliance of the psychiatrists who had to ensure that patients obtained treatment for all their health conditions aside of schizophrenia. The selection of an antipsychotic drug should be based on the clinical response and adverse side-effects. Relapses could require the use of another drug which was immediately efficient. Iloperidone could be safe for treatment of schizophrenia especially for those who could not tolerate other antipsychotics. Adults with acute relapses of schizophrenia could be treated efficiently for short terms with Paliperidone ER. Paliperidone was mainly selected for acute phase and maintenance of treatment. Lurasidone had a good metabolic profile with low levels of extra-pyramidal symptoms. The risk of vomiting, nausea and dizziness must be remembered before prescription. Cognitive behavior therapy was an essential component of effective management. The quality and efficacy of improving the management of schizophrenia was possible through modified psychosocial rehabilitation programmes (Valencia et al, 2010). Future research needs to investigate the change in quality of life using a combination of factors as mentioned here. The results could change the future for these patients. References: Arif, S.A. and Mitchell, M.M. (2011). Iloperidone: A new drug for treatment of schizophrenia. Clinical review. Am. J. of Health –Syst Pharm. 68:301-308 Bick, P., Knoesen, N. and Castle, D. (2007). Clinical implications of the CATIE schizophrenia Trial: Day-to-day management lessons for Australasian psychiatrists. Australasian Psychiatry, 15(6): 465-469 Chwieduk, C.M. and Keating, G.M. (2010). Palliperidone Extended release: A review of its use in the management of schizophrenia. Drugs, 70(10): 1295-1317 Draper, M.L., Stutes, D.S., Maples, N.J. and Velligan, D.I. (2009). Cognitive adaptation training for outpatients with schizophrenia. Inc. J. Clin. Psychol: In session, 65: 842-853. Wiley Periodicals. John Wiley and Sons Inc. Ehret, M.J., Sopko, M. and Lemieux, T. (2010). Focus on lurasidone: A new atypical antipsychotic for the treatment of schizophrenia. Formulary. 45: 313-317 Kuller, A.M., Ott, B.D., Goisman, R.M., Wainwright, L.D. and Rabin, R.J. (2010). Cognitive behavioral therapy and schizophrenia: A survey of clinical practices and views on efficacy in the United States and the United Kingdom. Community Mental Health J. 46:2-9. Springer Science and Business Media Valencia, M., Rascon, M.L., Juarez, F., Escamilla, R., Saracco, R. and Liberman, P. (2010). Application in Mexico of Psychosocial Rehabilitation with schizophrenic patients. Psychiatry 73(3):248:263 Read More