A brief discussion on the key points of diagnosis and treatment of schizophrenia

  Abnormalities in speech and behavior in patients with schizophrenia are not obvious in the early stages, but they are not completely untraceable. They tend to gradually develop speech and behavior disorders, do things with little purpose, and sometimes speak incoherently. There is a subtle but deeper change in the person’s mental state than before the illness, giving a sense of “puzzlement”.  Simply put, the person’s speech and behavior is so out of character with his/her age, gender, identity, social role, consistent patterns of speech and behavior, and the local social context at the time that it is incomprehensible and therefore unbelievable.  And there are many misconceptions and questions about the main points of treatment for schizophrenia.  To summarize, the following questions are more common: First, should it be treated and how should it be treated. Although there is a so-called remission period for schizophrenia, it will not be cured without systematic treatment through medication relying on so-called regulation of one’s own will, etc.  Currently, in the field of mental health, the best treatment plan for schizophrenia is recognized to be medication-based, supplemented by psycho-behavioral cognitive treatment, with an emphasis on whole-course treatment.  Timely early intervention, reasonable and effective acute treatment, and long and stable late maintenance treatment are the best guarantees for patients to return to society as soon as possible.  Second, the choice of drugs.  Many families believe that all Western drugs have side effects, and that antipsychotic drugs take a long time, and some have obvious side effects such as dry mouth and drowsiness. Therefore, they tend to ask the doctor to take the smallest amount of medication possible, or ask for Chinese medicine treatment because they think that Chinese medicine has no side effects.  In fact, all drugs have side effects, but as long as they are under the close observation and control of the doctor and do not seriously interfere with the treatment process, there is no need to worry about them.  Some people misunderstand that antipsychotic drugs act on the brain and worry that they will make people “stupid” or something.  The current antipsychotic drugs achieve their therapeutic effect by improving the metabolic regulation of neurotransmitters in the body, and when used reasonably within the effective dose, in principle, they do not cause irreversible damage to the brain.  Moreover, modern drugs need to go through extremely strict multiple clinical trials, and their safety has been greatly improved compared with the previous ones.  Third, the problem of the continuation of drug treatment. In view of the easy relapse of the disease, it is generally recommended that the duration of antipsychotic drug treatment be basically measured in years.  Those patients whose clinical symptoms are basically controlled and disappeared after treatment are still recommended to adhere to medication for about 3~5 years. And for some patients with multiple recurrent episodes over the years, the doctor’s recommendation is to take medication for a long time.  Fourth, what is the standard of cure. At present, the cause of schizophrenia is not completely clear, and clinical treatment is a symptomatic treatment, which means that the first criterion for cure is to reduce or eliminate its symptoms such as hallucinations and delusions. The process of medication should also be accompanied by psycho-behavioral cognitive therapy, so that patients can have a better understanding of their illness, understand and criticize their symptoms, accept to take medication on their own for years, and eventually partially recover their social functions and be able to go out into society and engage in work that they can do.  Finally, we talk about the rehabilitation period. Patients should have a regular and reasonable diet, personal hygiene, encourage self-care, cultivate certain hobbies and interests, and pay attention to training their attention, memory, language expression and emotional communication. In the patient’s long life path, treatment in the acute phase is, after all, short-lived; psychiatric rehabilitation is to last a lifetime. Current treatment for schizophrenia has evolved from simple symptom control to social functioning rehabilitation.  A reasonable treatment plan can help the person better achieve social function rehabilitation and return to society as soon as possible.  This is a long-term process, and the family, the patient, and the treating physician should maintain frequent contact to adjust the rehabilitation strategy and medication dosage in a timely manner. Only in this way can we ensure that people with schizophrenia receive good and effective treatment and support.