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A guide for the care and treatment of patients with schizophrenia

What is schizophrenia?

Schizophrenia is a biological brain disorder that seriously affects a person ability to think clearly and relate to others. People with schizophrenia have difficulty distinguishing between what is real and what is imaginary and can be folded or have difficulty in everyday situations.

Schizophrenia usually develops in adolescence or adulthood, although it may occur later in life. Schizophrenia usually progresses slowly and varies in its severity patients.

What are the symptoms of schizophrenia?

Symptoms of schizophrenia are generally classified as one of three types:

Positive symptoms: abnormal or exaggerated behavior or thought patterns that are "added" by an individual to interact with the world. These include visual, auditory and / or tactile hallucinations (seeing, hearing, and the feeling that things are not there), delusions (persistent false beliefs that are not changed by reason or evidence), paranoid delusions, or disorganized thought processes and speech unusual. Side effects of medications or symptoms also include movement disorders, including clumsiness, incoordination or involuntary movements, and, rarely, catatonic.

Negative symptoms: the absence, loss or reduction of normal behavior, emotions, and modes of thought. Examples include blunted emotions, inability to start and monitor activities, social withdrawal, neglect of hygiene, and discontent or disinterest in life.

Cognitive symptoms: difficulty with attention, memory and executive functions that interfere with normal daily activities.

As the disease progresses, These symptoms often become more intense. Schizophrenia often works in cycles, which means the disease can get better and then again at a later date.

What is the history of schizophrenia?

Although the word "schizophrenia" is less than 100 years, the disease itself does generally believed to have been present in humans since the beginning of humanity. It was not until 1887, however, that was first recognized as a discrete mental disorder by the German physician Emil Kraepelin. He used the term dementia praecox "(meaning early dementia ") for patients who had symptoms that are now associated with schizophrenia. In 1911, Eugen Bleuler, Swiss psychiatrist, coined the term 'schizophrenia' (derived from the Greek word "schizo" meaning "divide", and phrenic, which means "spirit").

He also the first to characterize the symptoms to be "positive" or "negative". Bleuler thought dementia praecox is misleading because the disease was not a form of dementia and may occur early and late in life. He therefore believes that schizophrenia is a better name appropriate and sent the fragmented thought processes of people who suffer from the disease.

How many people suffer from schizophrenia?

Globally, an estimated 1 in every 100 develops schizophrenia. There are currently more than 2 million Americans who suffer from schizophrenia, with men and women affected equally. Due to the age of onset typically occurs early and throughout the burden of disease on patients emotional and physical well-being, schizophrenia can be considered one of the most debilitating medical.
According to the American Psychiatric Association, patients with schizophrenia occupy more hospital beds than patients with almost any other disease. Federal costs of total disease between $ 30 billion and 48 billion dollars per annum when the direct medical costs, lost productivity, and security benefits Social considered.vi are an estimated 50% to 80% of patients with schizophrenia live with or have regular contact with family members who are in their caregivers. There is an enormous burden placed on the corresponding caregivers. Schizophrenia imposes significant personal, financial requirements, social and emotional on caregivers. Other estimates place so the overall cost of schizophrenia to nearly 63 billion dollars in direct health care, society, and family and caregiver costs are added.

How is schizophrenia treated?

Although the cause of schizophrenia remains unknown, antipsychotics can help people with Alzheimer's disease function more effectively and appropriately. In conjunction with counseling programs to help people manage and cope with their behavioral symptoms, these drugs were found significantly reduce psychotic symptoms and reduce the chances that symptoms will return. Two classes of antipsychotic drugs - classical (or typical) and atypical - are used to treat schizophrenia.

Conventional or typical antipsychotic drugs such as haloperidol, chlorpromazine, and fluphenazine, are effective in treating symptoms Positive schizophrenia. These older drugs, while effective in the treatment of symptoms of schizophrenia, have been in existence since the 1950s. The new atypical antipsychotics, such as paliperidone ER, risperidone, aripiprazole, olanzapine, quetiapine, and ziprasidone, are the most commonly prescribed treatments for schizophrenia. Available in oral and long-term and short-acting forms injectable atypical antipsychotics alleviate the positive symptoms and improve cognitive and negative symptoms of schizophrenia.

What role of continuity of treatment in people with schizophrenia?

For the millions of Americans who experience schizophrenia or other serious mental illnesses and their family members, one of the most critical periods for the recovery of an individual is the transition intense hospitalization (hospital) care institutions to community services. This continuity "of therapy is a process involving the order, uninterrupted movement of patients between various elements of service delivery. Specifically:

When one takes into account the complex nature of mental illness and multiple treatments and services needed by people seeking recovery, continuity of and coordination of care and treatment services are important factors to ensure the quality of mental health care.

Given the important role that drugs to play in reducing symptoms or mitigation, continuity of drug therapy should receive the highest priority.

A vision to address continuity of care and treatment
In some environments, systems designed to serve mentally ill and their caregivers are aware of serious deficiencies in the level and depth of communication, cooperation and coordination of treatment services and necessary to avoid fragmentation and discontinuity of service.
To remedy this, the National Council for Community Behavioral Healthcare has published recommended new approaches to ensure seamless continuity of treatment for people with schizophrenia and other mental illnesses serious. The National Council consensus statement was prepared by a group of 24 members consisting of leading accreditation organizations plan, hospital and community treatment organizations, patients, family members, researchers, government authorities, and leaders psychiatric. The results, presented at the 37th Annual National Conference of the organization, focusing on breaking down barriers between systems care. The panel developed recommendations that address the administrative aspects, and human resources professionals to ensure continuity comprehensive care.

Specific recommendations are as follows:

- Encourage collaboration between hospitals and community agencies

- Use an approach to improving quality in order to improve continuity of therapy by benchmarking performance and standards results in organizational

- Ensure that all patients have a level of care for managing the transition from hospital to community, including care management services reimbursable by all taxpayers

- Focus on the model of "Pull" of transition from hospital ambulatory care by involving community service providers in the transition before discharge patients

- Align accreditation standards continuity and improve therapy

- Educate patients and their families about the importance of maintaining a history of health care Personal

- Promoting a more informed use of hospital services to reduce the use of emergency rooms and possibly a reduce the number of hospitalizations

- Share data on mental health services with appropriate organizations in more usable and faster

- Involving patients and their advocates at all levels of system delivery and evaluation

REFERENCES:

Hazel NA, McDonell MG, Short RA, et al. Impact on multi-family groups for outpatients with schizophrenia on the plight of caregivers and resources. Psychiatric Services. 2004; 55:35-41.

McDonell MG, Short RA, Berry CM, Dyck DG. The burden of schizophrenia caregivers: impact of family psychoeducation and awareness of patient suicidality. Family Process. 2003; 42:91-103.

National Institute of Mental Health. Schizophrenia. U.S. Department of Health and Social Services. National Institutes of Health. Publication No. NIH 06-3517. Revised July 12, 2006.

Validation of the voice of new treatments for 'wits. Physician's Weekly. April 15, 2002, Vol. XIX, No. 15. Available at: http://www.physiciansweekly.com/article.asp?issueid=15&articleid=57&printable=1. Accessed September 12, 2006.

Schizophrenia facts and statistics. Available at: http://www.schizophrenia.com/szfacts.htm. Accessed September Six, 2006.

overview schizophrenia. Available at: overview.asp http://www.healthyplace.com/communities/thought_disorders/site/schizophrenia_. Accessed on September 12, 2006.

The history of schizophrenia. Available at: http://www.schizophrenia.com/history.htm. Accessed September 6, 2006.

What's this? Overview of schizophrenia. Available at: http://www.schizophrenia.com/family/sz.overview.htm. Accessed September 6, 2006.

About the Author

Linda Rosenberg is the president and CEO of the National Council for Community Behavioral Healthcare. TNC specializes in lobbying for research toward the diagnosis and treatment of mental illness and substance abuse. Lean more at www.thenationalcouncil.org.

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