Can schizophrenia be cured?
The famous psychiatrist Brule points out that there are four possibilities for the prognosis outcome of schizophrenia, namely, cure, mild deficits (meaning social deficits), severe deficits and dementia. Some psychiatric patients receive timely and systematic inpatient treatment early, continue to have regular outpatient reviews after discharge, adhere to their medication as prescribed, and receive good psychological support from their families and society, resulting in lifelong freedom from the disease and the ability to do their original work well. Such a patient has only one attack in his or her life and should be said to be cured. After the first episode of schizophrenia is “cured”, the disease can be cured by taking medication for a long time and avoiding all kinds of factors that cause relapse.
Clinical manifestations involve all aspects of human mental activity
Schizophrenia involves all aspects of human mental activity and is characterized by multidimensional symptoms, i.e., positive symptoms, negative symptoms, mood disorders, aggressive behavior, and cognitive dysfunction.
Positive symptoms, such as hallucinations, delusions, thought disorders, speech disorders, catatonia, etc.
negative symptoms, such as affective indifference, paucity of thought, diminished volition, lack of interest, social withdrawal
Mood disorders, such as anxiety, depression, suicidal ideation and behaviour
aggressive behaviors, such as excitement, hostility, impulsivity, agitation, uncooperativeness.
Cognitive impairment, such as impaired attention, memory, and executive function.
The above five-dimensional symptoms lead to reduced social functioning, decreased social, work, and learning abilities, difficulties in interpersonal relationships, and negligent self-care. Due to the multidimensional nature of schizophrenia symptoms, comprehensive treatment is required. Schizophrenia is a chronic recurrent or worsening migratory disease, and the course of the disease can be divided into an acute phase, a consolidation and stabilization phase, a relapse and worsening phase, and a chronic phase. The above characteristics of the course of schizophrenia require long-term phased treatment of the entire course of the disease. Active treatment throughout the course of the disease will significantly improve the prognosis of patients.
Pharmacological treatment as the main tool
Medication is currently the mainstay of schizophrenia treatment. Medication is safe, effective, available, easy to use, and has high patient compliance. Depending on whether the treatment is acute or chronic, and whether positive or negative symptoms predominate, targeted medications are selected, in principle starting with a small amount and gradually increasing, and gradually decreasing when the patient improves, with a small amount of medication to maintain treatment. If the patient does not cooperate in taking the medication, it can be applied intramuscularly or intravenously for a short period of time, and then be changed to oral medication after cooperation. During the recovery period and prevention period, a small amount of the above antipsychotic drugs can be given orally, or long-acting drugs can be given orally or intramuscularly.
Treatment goals
Acute treatment goals
① Eliminate the main symptoms and strive for clinical remission.
②Prevent the occurrence of suicidal and impulsive behaviors.
③ Minimize adverse drug reactions and prevent the occurrence of serious adverse reactions.
④Prepare for the restoration of social function and return to society.
Treatment goals during the consolidation and stabilization period.
①Preventing the relapse of symptoms.
② control of post-schizophrenic depression or obsessive-compulsive symptoms.
③Preventing suicide.
④Control and prevention of long-term adverse drug reactions.
⑤ Promote return to society.
Maintenance treatment goals for relapse prevention.
①Preventing relapse and deterioration of the disease.
②Improve patient compliance with treatment.
③ Restoration of social function.
④ Enhance the ability to cope with physical illness and psychological stress.