Management of Schizophrenia

Management of schizophrenia depends largely on medications and on psychosocial interventions. No single approach is widely considered effective for all patients, though in the United States and most Western countries, psychiatric medication is often the primary method of treatment. Currently, there is a movement towards utilizing a recovery model that emphasizes hope, empowerment and social inclusion, though this is not yet a mainstream mental health concept .

Criteria for the remission of symptoms were suggested in 2006. Management of symptoms and improving function may be more achievable than a permanent cure .

Antipsychotics have been a mainstay of therapy since the introduction of chlorpromazine in the mid-1950s, which revolutionized treatment. Significant adverse effects have attracted controversy. Older concerns of sedation, tardive dyskinesia and neuroleptic malignant syndrome have been largely replaced with those of drug-related obesity and diabetes.

In many non-Western societies, schizophrenia may only be treated with more informal, community-led methods. The outcome for people diagnosed with schizophrenia in non-Western countries may actually be better than for people in the West. The reasons for this effect are not clear, although cross-cultural studies are being conducted.

The effectiveness of interventions is often assessed using standardized methods, one of the most common being the Positive and Negative Syndrome Scale (PANSS). This instrument only measures the presence of psychiatric symptoms, and does not adequately assess the characteristics of the recovery model which emphasize psychosocial constructs of recovery, such as hope, identity formation, empowerment and social inclusion.