Schizophrenia: Chronic and Severe Mental Disorders

As we know, schizophrenia and its spectrum disorders are chronic and severe mental disorders that affect an individual in many aspects of life. These disorders impact the ability to think and feel and also affect behavior. This means that people with schizophrenia may seem as if they have lost touch with reality. Sometimes, diagnoses can be difficult as there are no specific tests and the only way to identify it is to recognize symptoms that negatively impact an individual's social or occupational functioning.

Until recently, schizophrenia showed very little response to any existing method of treatment. However, it's argued that with psychosocial treatment, people suffering from schizophrenia have a chance to adjust socially and improve their well-being overall.

Defined by the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, schizophrenia is a long-term disorder that can be characterized by bizarre delusions, catatonic behavior, disorganized speech, a high relapse rate (70%), and negative symptoms such as diminished emotional expression. Usually, the disorder affects people in their late adolescence or early adult life, but there are cases in which children have been diagnosed too. There are many theories about what causes schizophrenia. Some people believe that it's genetic, others think that it could be due to physical factors like brain damage, metabolic or endocrine disorders, while others believe schizophrenia can only be understood in terms of psychological factors, meaning that mental conflicts and repressions are the main causes. However, there are also people who believe that there cannot be simply one cause for schizophrenia—in other words, it arises from a combination of causes such as hereditary, organic, or psychogenic factors, says Bowman (1939).

According to Bustillo, Lauriello, Horan, & Samuel (2001), antipsychotic medications have been effective for people suffering from schizophrenia. However, apart from clozapine, none showed any benefits in different domains, such as social adjustment, employment, etc. This means that most people suffering from schizophrenia still experienced impaired social functioning and had negative symptoms even when taking medication. Therefore, Bustillo, Lauriello, Horan, and Samuel (2001) state that it's extremely important to integrate psychosocial treatment into the standard of care for people diagnosed with schizophrenia. They argue that without psychosocial treatment, the probability of experiencing a relapse is higher.

Family work or psychoeducation may significantly improve the life of a person diagnosed with schizophrenia, state Mueser, Deavers, Penn, & Cassisi (2013). The main reason is that many patients live at home with family or relatives or maintain close relationships with somebody from their family. However, many people do not know how to cope with someone who has schizophrenia, which may lead to high levels of family burden and family stress, potentially causing a relapse. Family psychoeducation aims to develop collaborative relationships between the family and the treatment team, ensuring progress in treatment. Educating relatives of a person with schizophrenia about how to reduce stress, improve communication, and enhance problem-solving skills has proven beneficial, say Mueser, Deavers, Penn, & Cassisi (2013). Moreover, researchers argue that more than 50 studies conducted show that family psychoeducation is extremely beneficial for individuals with schizophrenia as it reduces the number of relapses and slightly improves social functioning.

Another thing that can improve the life of someone with schizophrenia is social skill training. According to Bustillo, Lauriello, Horan, & Samuel (2001), social skill training through learning theory improves social functioning. In other words, working with people suffering from schizophrenia to teach them how to solve problems in their daily lives, leisure, and relationships. There are three main forms of social skill training, as stated by Bellack and Mueser (2001). The basic model is a strategy where complex things are broken into simpler ones, and people practice by role-playing, attempting to apply everything in natural settings. Another strategy is called the social problem-solving model. It focuses on improving social skill deficits by ameliorating impairments in information processing. The cognitive remediation model improves aspects like attention and planning. Bustillo, Lauriello, Horan, & Samuel (2001) state that cognitive impairment can be improved, suggesting that all this learning may support more complex cognitive processes. If successfully taught and generalized in the community, it proves to be beneficial for people with schizophrenia.

Furthermore, there is another psychosocial recovery model proven to be beneficial for people with schizophrenia. According to Mueser, Deavers, Penn, & Cassisi (2013), self-management training involves people in their own treatment by teaching them self-management strategies. In the beginning, people suffering from schizophrenia are usually provided with information about the disorder, enabling them to make informed decisions about their treatment and care. In addition, patients are taught to take medication as prescribed because medication nonadherence is a common reason for relapse, according to Mueser, Deavers, Penn, & Cassisi (2013). People with schizophrenia may also learn how to cope with relapses since medication can't always prevent them. Mueser, Deavers, Penn, & Cassisi (2013) argue that self-management training helps people learn to manage their illness more effectively, offering information and skills training to ease the patient's life through learning about schizophrenia, medication, relapse prevention, and strategies that help to cope with symptoms.

In conclusion, psychosocial treatment has proven beneficial for people with schizophrenia due to its ability to improve a wide range of social impairments. For instance, people learn how to function at work, form social relationships, enhance independent living skills, and prevent and cope with relapses. However, further research should be directed towards questions like how to combine medication and psychosocial treatment so that patients can recover faster with lower risks of experiencing a relapse.

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