A person reading schizophrenia treatment guidelines while walking with a dog and a child.

Artwork by Rohan Francis

A person reading schizophrenia treatment guidelines while walking with a dog and a child.

Managing Schizophrenia: Treatment Guidelines Explored

Medically reviewed by

Written by Parth Sharma

Schizophrenia is a chronic mental disorder that affects how a person thinks, acts, perceives reality, and relates to others. It involves psychosis, a mental illness wherein a person can’t tell what’s real from what’s imagined. 

A person with Schizophrenia can show a sudden change in personality and behavior, which happens when they lose touch with reality during a psychotic episode. In which the world may seem confusing, and thoughts, images, and sounds may seem messy. 

When it comes to treatment, it's crucial to follow established guidelines tailored to the individual's needs. This includes a combination of medication, psychotherapy, and lifestyle adjustments. For childhood schizophrenia, early intervention is key. Childhood schizophrenia treatment guidelines often involve a team approach, including child psychologists, psychiatrists, and educational specialists. The goal is to manage symptoms effectively while supporting the child’s development and education.

Schizophrenia Causes and Risk Factors

Researchers believe that a combination of genetics, brain chemistry, and environment contributes to the development of schizophrenia.

Problems occurring in the brain chemicals such as neurotransmitters may contribute to schizophrenia. Neuroimaging studies show differences in the brain structure and central nervous system of people with schizophrenia. While researchers aren't sure about the significance of these changes, they indicate that schizophrenia is a brain disease.

Recent studies and guidelines continue to shed light on these aspects. For instance, the latest findings from genome-wide association studies (GWAS) have identified specific genetic variations linked to schizophrenia. Additionally, ongoing research in neuroimaging is helping to clarify the role of brain structure changes in the disease.

Researchers have also utilized positron emission tomography (PET) scans with a tracer to observe the SV2A protein in the brain. They found that individuals with schizophrenia had lower levels of this protein in brain regions associated with planning, though the implications of this finding for schizophrenia are still being explored.​

Diagnosing Schizophrenia: Criteria and Process

Schizophrenia can be identified within a person based on the various symptoms, including delusions, Hallucinations, and Catatonia. 

Delusions

Delusions are defined as beliefs that conflict with reality. Delusions are the most common symptoms of schizophrenia and can be related to persecution, grandiosity, and somatic. 

Hallucinations

Hallucinations are defined as experiences and sensations that are not understandable to others. To the person experiencing them, however, they may seem tangible, urgent, and vivid. They are visual, auditory, olfactory, or tactile.

Catatonia

Catatonia refers to a set of symptoms that might develop. It includes periods where the person with schizophrenia moves very little and does not respond to instructions.

The diagnosis of Schizophrenia is made by determining how these symptoms are based on no other illness or disorder but due to Schizophrenia itself. 

A mental health professional can diagnose Schizophrenia through-

  1. Psychiatric Evaluation: This method includes learning about personal and family history. The mood, appearance, cognitive abilities, and thoughts of delusion and hallucination are observed.
  2. Physiological Tests: A physical exam is conducted by the doctors to rule out the symptoms of Schizophrenia to be due to substance abuse. They may also conduct neuroimaging. 
  3. DSM criteria: The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, is used by mental health professionals to diagnose symptoms of Schizophrenia based on its type, the period of recurrence, and its effects.

According to the DSM criteria, a person must have at least two of the following symptoms for a month:

They must also experience considerable impairment in their ability to function in school or at work, interact with others, or carry out self-care tasks. They must have symptoms that persist for six months or more.

The American Psychiatric Association (APA) and WHO have revised schizophrenia diagnosis guidelines, emphasizing:

  • No Subtypes: Moving away from categorizing schizophrenia into subtypes like paranoid schizophrenia.
  • Symptom Reassessment: Shifting focus on symptoms like delusions and hallucinations.
  • Rating System: Introducing a system to assess both mental and physical symptoms.

Comprehensive Treatment Approaches for Schizophrenia

“The first challenge to treating Schizophrenia is helping the individuals understand that they are fighting the disorder. This is called developing insight. Most treatment begins after insight is developed,” reflects Dr. Arun, Consultant Psychiatrist, Cadabams Group.

Schizophrenia is a chronic illness, and people with Schizophrenia often require lifelong support during their treatment. The two methods used to treat Schizophrenia are medication and therapy. Caregivers for people with Schizophrenia give consent to supported admission for the treatment of their loved one at a hospital or clinic if and when, in the event of a violent psychotic episode, the person is at risk of hurting themselves or the people around them. 

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Medications in Schizophrenia Treatment: Guidelines and Options

Antipsychotic medication for Schizophrenia is a widely used method of treatment. The goal of treatment with antipsychotic drugs is to manage signs and symptoms at the lowest possible dose effectively. The medication can be administered orally or via injections.

Oral medication

First Generation Antipsychotic medications are cheaper medications in the long run but have significant neurological side effects on the body. Second-generation antipsychotic medications such as Aripiprazole (Abilify), Asenapine (Saphris), Brexpiprazole (Rexulti), and Cariprazine (Vraylar) are thus widely used due to their lower risk of side effects. Because medications for Schizophrenia can cause serious side effects, people with schizophrenia may be reluctant to take them. Willingness to cooperate with schizophrenia treatment guidelines may affect drug choice. For instance, someone resistant to taking medication in time may need injections instead of taking a pill. 

Different atypical antipsychotics may cause different side effects. Some common issues may include Weight gain, Higher blood sugar and cholesterol levels, Low blood pressure, Drowsiness, and blurry vision.

Injectable Antipsychotics

Antipsychotics can be given as an intramuscular or subcutaneous injection. They are usually given every two to four weeks, depending on the medication. This may be an option if someone prefers fewer pills and may help with adherence if the person cannot follow medicines as per the recommended routine. 

Monitoring and Adjustment

Regular monitoring for side effects, such as weight gain, metabolic changes, and movement disorders, is crucial. Dosages may need to be adjusted based on the patient's response and tolerance.

Psychosocial and Therapeutic Interventions in Schizophrenia

While medication helps relieve symptoms of schizophrenia, various psychosocial treatments can help with the behavioral, psychological, and social dysfunctions that go with the illness. Through therapy, people with schizophrenia can also learn to manage their symptoms, identify early relapse warning signs, and develop a relapse prevention plan. 

Cognitive Behavioural Therapy (CBT)

‍Cognitive Behavioural Therapy helps the person change their thinking and behavior. The symptoms of schizophrenia are often delusions and hallucinations, where the person may feel disconnected from reality. With a combination of CBT sessions and medication, people with schizophrenia can identify their lack of control as a symptom of schizophrenia instead of the paranoia of hearing and seeing things. Therapy allows one to identify what triggers their psychotic episodes and how to reduce or stop them. 

‍Electroconvulsive Therapy (ECT)

Electroconvulsive therapy is a procedure done under general anesthesia. Small electric currents are passed through the brain, intentionally triggering a brief seizure. ECT seems to cause changes in brain chemistry that can quickly reverse symptoms of certain mental health conditions such as Schizophrenia and mood Disorders. ECT often works when other treatments are unsuccessful, and the entire course of schizophrenia treatment guidelines is completed, but it may not work for everyone.

Family Therapy

‍People with schizophrenia often rely on family members for their primary care and support. Caregiver burnout and exhaustion can strain any family, with caregivers feeling guilty for taking time off for their own life or being abandoned by their loved one seeking treatment guidelines for schizophrenia. Family therapy is a way of helping the caregiver and their loved one cope better with their condition. It involves a series of meetings for around six months. Sessions may include:

  • Discussing information about schizophrenia.
  • Exploring ways of supporting somebody with schizophrenia.
  • Deciding how to solve problems that the symptoms of schizophrenia can cause within family settings.

Schizophrenia is a chronic condition that significantly impacts a person’s ability to function in life. Schizophrenia has no cure, though varied schizophrenia treatment guidelines are available to help one manage their symptoms. People with schizophrenia benefit considerably from the support of their family, friends, and community services. They benefit from medication and treatment and can recover from this illness. 

Transcranial magnetic stimulation (TMS)

Transcranial magnetic stimulation is a very effective treatment option for those battling schizophrenia. Under the guidance of a trained mental health professional, different parts of a person’s brain are stimulated to accelerate recovery and reduce symptoms. 

Deep brain stimulation (DBS)

Deep Brain Stimulation includes surgically implanting electrodes in different areas of the brain to modulate neural activity. It is an experimental approach to treat schizophrenia. The aim is to reduce symptoms by targeting brain circuits involved in the disorder.

Experiential Therapy

This type of therapy focuses on using expressive tools and activities, such as role-playing or art. The goal is to help individuals with schizophrenia express themselves and process their feelings in a therapeutic setting under the guidance of an expert.

Dialectal Behaviour Therapy (DBT)

DBT is a cognitive-behavioral approach tailored to help individuals manage emotions and reduce conflict in relationships. It's used in schizophrenia treatment to improve emotional regulation and decrease self-harm behaviors.

Childhood Schizophrenia Treatment: Special Considerations

Early Signs and Diagnosis of Schizophrenia in Children

Early signs of schizophrenia in children included delayed development of language skills, unusual physical movement, and social withdrawal. Diagnosis usually involves being interviewed by a psychiatrist and multiple diagnostic tests and psychometric assessments.  

Choosing the Right Medication

Choosing the right medication is an important part of the treatment of schizophrenia in children. The consulting psychiatrist will take some time to arrive at the right type and dosage of medication for the child who is recovering. This is a crucial period since medication plays an important role in reducing symptoms. 

Family Involvement and Education

Families play an important role in the recovery of an individual from schizophrenia, especially in the case of schizophrenia. One of the most important steps the family can take is to educate themselves about the early signs of the disorder, treatment approaches that are effective, and how to make recovery easier for the child. 

School-Based Support and Accommodations

Education is an important part of childhood development, and for children with schizophrenia, having adequate support from their teachers and fellow students becomes important. Schools must make accommodations to create stress-free learning environments for the child. 

Social Skills and Peer Interactions

Programs focusing on social skills training can help children with schizophrenia improve their communication, understand social cues, and build healthier peer relationships. This also plays a role in enhancing their social integration, a major challenge with the disorder in general. 

Long-Term Care Planning

Long-term planning involves predicting future needs, vocational training, independent living skills, and mental health services. A collaborative effort among families, caregivers, and professionals is needed to ensure continuous support and quality of life.

Advancing Current Treatments and Addressing Challenges in Schizophrenia Care

The future of schizophrenia treatment guidelines holds promise, but the focus remains on enhancing the effectiveness of current therapies. A significant challenge is that nearly half of those with schizophrenia are not receiving treatment. Increasing awareness about symptoms, improving access to treatment options, and expanding mental health services are critical steps to address this issue. Additionally, it's vital for mental health programs to actively combat the stigma and prejudice faced by individuals with mental illnesses, creating a more supportive and understanding environment for those in need of care.

Supporting Your Journey Through Schizophrenia Treatment Guidelines at Cadabams

A loved one is fighting Schizophrenia, and you are looking for treatment options. You run through hospitals, professionals, and centers, changing each as the nature and severity of the illness change. It’s harrowing.

That is where we come in. We have built a comprehensive mental healthcare infrastructure that promises to cater to all of your treatment needs. Once you step into Cadabams, you will never need to go anywhere else. From OPD consultations to hospitalization to personalized rehabilitation plans, we offer it all. 

If you are searching for a solution to your problem, Cadabam’s Rehabilitation Centre can help you with its team of specialized experts. We have been helping thousands of people live healthier and happier lives for 30+ years. We leverage evidence-based approaches and holistic treatment methods to help individuals effectively manage their schizophrenia. Get in touch with us today. You can call us at +91 96111 94949

Book screening with our director of triage,  Kamlesh Verma

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FAQs

1. What is the best treatment for schizophrenia?

There are multiple treatments for schizophrenia, including medication and therapy. Rehabilitation for schizophrenia is seen to be the most effective treatment option since it involves a combination of medication, therapy, supportive treatments, and more. 

2. How long is schizophrenia therapy?

There is no set time period for which therapy lasts. Your mental health professional will suggest the number of sessions and frequency. It is crucial to stick to the suggested treatment plan to ensure optimal recovery.

3. What is the first line of treatment for schizophrenia?

The first line of treatment for schizophrenia is usually medication. Prescribed by a psychiatrist, medication allows for a reduction in the frequency and intensity of certain symptoms of the disorder.

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