Patient: Hi, Dr. Chiang, you said, “In 10 years, maybe you will know. Go listen to the opinions of those who have been there. The disability rate of schizophrenia is as high as 70-80%. “Why is the disability rate of schizophrenia so high? Does it mean that schizophrenia must be treated thoroughly in high doses ah, to be completely free of psychotic symptoms and then maintained for quite a long time, right? Jiang Xiaojun, Psychiatry Department, Nanjing Brain Hospital: It is because of the inability to achieve “full dosage and full course of treatment” that the disability rate is so high. Therefore, schizophrenia must be treated at high doses, with no psychotic symptoms at all and then maintained for a long time. Data show that the first treatment for schizophrenia is more than 80% effective, but after repeated relapses, only 20% of the patients remain normal. We have known for decades that “the disability rate for schizophrenia is as high as 70-80%.” . This is why we strongly emphasize that the first treatment of schizophrenia must be “adequate and full course of treatment”. Relapse should be firmly avoided. This makes it possible to maintain the efficacy of the first treatment. Patient: Well, thank you for your help. Why is the disability rate of schizophrenia so high? If you follow the high dose treatment you mentioned, is it still easy to relapse after the high dose is maintained for a considerable period of time? What is the relapse rate and what is the condition afterwards? Nanjing Brain Hospital psychiatric department Jiang Xiaojun: high dose treatment, high dose maintenance of the relapse rate. There is no statistical information on this. However, experience shows that long-term stable patients: 1. can live, study and work normally while being treated. 2. 2.Even if they relapse after many years, the disease is not serious and easy to treat. 3. After the age of 30, the patient has a marriage and family and a job. Even if the disease fluctuates and requires long-term medication. There is basically no impact on the patient’s life and future. Therefore, I personally believe that the treatment of schizophrenia should be maintained at least until the patient is 30-35 years old. The younger the age of onset, the longer the duration of treatment. 3-5 years of maintenance treatment for patients over 35 years of age. (It must be emphasized that the maintenance treatment period must be free of any psychotic symptoms!) 4. On the contrary, if recurrent episodes occur within 1-2 years of treatment, the social functioning of most patients is severely affected. They are usually unable to complete their education, get married or participate in the workforce. Eventually the patient is excluded from normal society. 5. Data show that the first treatment for schizophrenia is effective up to 80% or more. Most relapses are due to inadequate treatment and premature medication reduction and discontinuation. If we maintain the intensity of treatment after the first treatment so that the condition does not relapse, it is entirely possible that the efficacy of schizophrenia will reach more than 50%. This would likely be a huge advance in the treatment of schizophrenia. 6. It is the advantages of second-generation antipsychotics that make it possible for us to achieve high-dose treatment and high-dose maintenance.